I industry report _ composite restorations Smile upgrade— Highly aesthetic composite restorations in the anterior region Author_ Dr Ronald D. Jackson, USA Figs. 1 & 2_Female patient with a prominent white spot on the right central incisor: The influence of the white spot on full face appearance is clearly visible. Figs. 3 & 4_This ‘appearance lesion’ was treated with a conservative IPS Empress Direct restoration, showing that a small treatment can have a significant effect on the overall image. Note that the patient underwent tooth bleaching prior to the placement of the restoration. Fig. 1 Fig. 2 _The emphasis on appearance is pervasive in today’s media-driven culture. It is particularly keen in adolescents as a result of constant exposure to images of beautiful young celebrities (real or media-created) in magazines, television, pop music and everywhere on the Web. Because the smile is such a significant factor in facial appearance, the impact of this culture shift on dentistry has been enormous. In particular, young teenagers are seeking out aesthetically oriented dentists and requesting correction of mild to moderate imperfections in teeth that previous generations tolerated because dentistry lacked a simple, predictable aesthetic solution (Figs. 1–4). _History and diagnosis A sixteen-year-old female patient presented with the chief complaint of being dissatisfied with the previous dental treatment of her maxillary central incisors. Her dental history revealed that she had large white spot lesions in the incisal one third of each of these teeth, which she said appeared following orthodontic treatment. She had seen a dentist several months earlier, who placed composite resin restorations in both centrals, but she was dissatisfied with the result (Fig. 5). The clinical examination showed these Fig. 3 Fig. 4 44 I cosmetic dentistry 4_ 2009