Smile not only reveals self-confidence in an individual but also helps to express a range of emotions coordinated with the movement of the teeth and lips.

This report presents the case of a 51-year-old lady who walked into our clinic and was not very happy with the shape, size, and color of her front teeth which she also found to be more yellowish. The patient did undergo a number of dental procedures previously especially for her front teeth including fillings, root canals, crown/cap placement at different time periods at different centers outside as and when required.

But all these different procedures done as per the requirement of the time were unable to provide her a full-fledged aesthetic smile. Finally, she decided to get all the things corrected under one roof and that too in a specific time period as she was planning to move out of India very soon.

Understanding the patient's needs a detailed treatment plan was advised for her which includes the replacement of old crowns with new zirconia crowns. The treatment plan was addressed and executed in a phase-wise manner.

What Is A Crown?

A crown is a tooth-shaped “cap” that’s placed over a weak/ damaged tooth to improve its shape, size, strength, and appearance.

A Brief About Zirconia Crowns:

• One of the biggest advantages of Zirconia is its strength and durability.
• As Zirconia is strong it does not require much tooth preparation/ cutting thus preserving the natural tooth structure. 
• Also, Zirconia is the material of choice because of its good longevity and biocompatibility, which means it is less likely to provoke any inflammation
• The product is 100% metal-free, thus preventing gingival darkening and removing the possibility of exposing metallic margins if gum recession begins.
• Layered Zirconia is more translucent, naturally esthetic, and can easily match the shade of the adjacent teeth.

Below is the pre-operative image of the patient showing disproportionate teeth:

The facially generated aesthetic treatment plan is generated which involves the aesthetic analysis of the case. The smile must complement the facial features, both vertically and horizontally. This helps in developing tooth positions aligned with parameters specific to a particular face thus complementing the full facial aesthetics.

Tooth Proportions and proper length to width ratios are evaluated carefully and are designed digitally.
Overall tooth proportions are another key and critically important assessment that must be made by the clinician during the initial evaluation.

When asked about the shade before digital planning it was found that the patient was willing for whiter teeth. Understanding the patient’s needs a digital smile comparing the 'before-and-after' image was designed for her accordingly before the start of the treatment.

After overall assessment and proper evaluation of the recorded measurements including the facial features, the actual treatment was started for the patient. In the initial phase of the treatment, all of her old prosthesis/crowns which were deteriorating the cosmetic appearance, having worn off, and leaky margins were removed.

Using the treatment plan as the guide, the tooth preparation was done very conservatively following the principles of tooth preparation and the impression was recorded using additional silicone impression material. Following this immediate computer-aided design/computer-aided manufacture (CAD/CAM) fabricated temporary crowns having a superior fit and better strength were delivered to the patient.

The patient was very much happy with the shade and shape of the temporary crowns hence these approved designs were then copied in the laboratory for the final restoration to be fabricated.

The intermediate step of the bisque trial or trial smile was performed to ensure the functional stability and shade of the final prosthesis with the patient.

Preserving the continuity in the form, function, and position the final, polished zirconia crowns were placed in situ. Required bite adjustment was made maintaining proper over jet-overbite providing balanced occlusion.

Recollecting the patient’s initial complaint these final Zirconia crowns were aesthetically more stable giving her a confident, pleasing smile. The patient was very much happy and stated that the final results of the treatment provided were much more than what she had expected and have helped her gain back her bright, radiant smile.