clinical technique _ smile design I Fig. 5_Cosmetic image. Fig. 6_Diagnostic wax-up and putty matrices. Fig. 5 Fig. 6 At her second consultation appointment, we confirmed the smile design and length combination she had previously selected by showing her a diagnostic wax-up of her upper and lower teeth (Fig. 6). Matrices were fabricated from the wax-ups before this appointment and used to make an upper and lower Slip-On Smile right on the patient’s teeth. We loaded the matrices with an A-1 bis-acryl temporary material (examples are Temphase, Kerr; Integrity, DENTSPLY Caulk; and PERFECtemp II, Discus Dental)— and seated them in the mouth. After the material was set, the matrix was removed; remaining on her teeth was a new smile. We took a series of photographs with the Slip-On Smile in place and the patient was ecstatic. She was able to see and feel what her teeth would look like before committing to any dental work (Fig. 7). The patient was truly amazed by this and wanted to wear the smile home to show her husband. Though the patient had loved the selected smile design and cosmetic image, she was not convinced about pursuing this treatment. This demonstrates that the Slip-On Smile is an important part of treatment presentation. She accepted the treatment as soon as she could experience her new smile first hand. We began her treatment with a combination of in-office and at-home whitening. The incisals of the canines and bicuspids showed acceptable results. We used this as a base shade, planning to make the lower veneers even lighter towards the front and the upper veneers slightly lighter than the lowers. As planned, teeth #6 to 12 were prepared for Microveneers in order to preserve as much natural, healthy tooth structure as possible. Tooth #5 had an existing crown that the patient wished to replace to match tooth #12; thus, the tooth was prepared for a zirconium crown at the same time. Digital photographs of the preparation shades were taken for our ceramic artist (Fig. 8). Once the preparations were finished and refined, it was time to provisionalise the teeth. While an assistant loaded a tray with alginate, hydrocolloid (Dux Dental) was expressed over the prepared teeth for an impression. Then the alginate-filled tray was seated in the mouth, directly onto the hydrocolloid. After a minute and a half, the impression was removed with a snap and handed off to an assistant to pour. In the laboratory, the impression was disinfected and dried. Next, Mach-2 PVS (Parkell) was dispensed into the impression to pour up the model on a vibrator. A fast-setting bite registration material (SuperDent, Darby Dental) was then placed directly onto the Mach-2 for a model base. In less than two minutes, an accurate, instant silicone model was ready on which to fabricate a provisional—all of which was completed outside the patient’s mouth by an assistant. Using the matrices made from the diagnostic wax-up and approved by the patient in her Slip-On Smile, the provisionals were fabricated. Fig. 7_Slip-On Smile full face. Fig. 7 cosmetic dentistry 4 _ 2009 I 19