Cosmetic Dentistry Case Study • Newport Beach
8 Porcelain Restorations • Layered E.max • Midline Correction • Gingival Recontouring • Digital Smile Design
The Patient’s Concern
This patient came to Newport Beach Dental Studio unhappy with the color, shape and overall appearance of her front teeth. She also had older composite bonding that had become stained over time and no longer created balanced or proportional tooth shapes.
In addition to the color and proportions, there were minor alignment discrepancies and a dental midline discrepancy that affected the overall symmetry of the smile. Her goal was a brighter, more refined result that looked cohesive as a whole rather than simply repairing individual areas of old bonding.
The treatment plan therefore evaluated tooth proportions, anterior alignment, central-incisor symmetry, dental midline, incisal-edge position, gingival architecture and the relationship of the teeth to one another before the definitive restorations were designed.
What We Changed
BEFORE
- Old and stained composite bonding
- Unbalanced and disproportionate tooth shapes
- Dental midline discrepancy
- Minor anterior alignment irregularities
- Warmer and inconsistent tooth color
- Uneven gingival and incisal relationships
AFTER
- Old composite bonding replaced with porcelain restorations
- More balanced tooth width-to-length proportions
- Improved dental midline
- Improved visual alignment and symmetry
- Brighter and more consistent tooth value
- Improved gingival and incisal relationships
Analyzing the Transformation
Midline & Smile Symmetry
One of the most important changes in this case was correction of the dental midline. The position of the central incisors strongly influences how the entire anterior smile is perceived. Incorporating the midline into the restorative design helped create a more centered and balanced appearance.
Replacing Old Composite Bonding
The existing composite bonding had aged, stained and contributed to irregular tooth proportions. Rather than continuing to add or repair composite in isolated areas, the anterior teeth were evaluated together so the new porcelain restorations could establish a more intentional relationship between tooth width, length, contour and alignment.
Proportion & Tooth Shape
The central incisors were redesigned to create a more balanced relationship in apparent width, length and facial contour. Transitional line angles and facial reflections were carefully considered because these details affect how wide or narrow a tooth appears.
Alignment & Incisal Design
Minor alignment discrepancies were incorporated into the restorative design. The incisal edges were refined to create a more intentional progression from the central incisors toward the lateral incisors and canines, improving the overall flow of the anterior smile without making every tooth look identical.
Color, Translucency & Character
The definitive restorations were completed in shade BL2 MT. Although the smile became significantly brighter, the goal was not simply to create uniformly white teeth. Layered E.max allowed the ceramics to incorporate translucency, depth, surface character and variations in light reflection for a more dimensional result.
The 50/50 photograph is especially useful because the original and final teeth can be evaluated within the same image. It demonstrates how changes in midline, color, contour, proportion and alignment work together to influence the overall appearance of the smile.
Designed With Intention
SmileCloud and exocad were incorporated into the planning and restorative design workflow to evaluate the dental midline, tooth proportions, alignment, symmetry and overall composition of the smile before the definitive ceramics were completed.
Digital planning provided an additional layer of visualization and communication, while the definitive layered E.max ceramics were completed in collaboration with a master laboratory technician.
Creating Better Tooth & Gingival Proportions
The surrounding gingival architecture was incorporated into the smile design as well. An esthetic gingivectomy was completed to refine the relationship between the teeth and gum tissue and improve the visible proportions of the anterior teeth.
Correcting the old bonding and redesigning the teeth alone would not address every proportional discrepancy. The teeth, gingival architecture, midline and incisal edges were therefore considered together as components of the same smile.
Completed in Three Appointments
This smile transformation was completed over three appointments, combining digital smile planning, preparation and a temporary smile design, followed by delivery of the definitive layered E.max restorations.
01 — CONSULTATION
The existing composite bonding, tooth color, proportions, dental midline, alignment and gingival architecture were evaluated. The proposed smile was planned digitally using SmileCloud and exocad.
02 — PREPARATION
The old composite bonding was addressed, the gingival architecture was refined with an esthetic gingivectomy, and the eight teeth were prepared for a combination of porcelain veneers and crowns. The patient left wearing a temporary smile design based on the planned proportions, midline and esthetics.
03 — FINAL DELIVERY
Approximately two weeks later, the patient returned for delivery of the definitive layered E.max restorations in shade BL2 MT. The ceramics were evaluated for fit, midline, proportions, symmetry, shade, contour and overall integration with the smile before final delivery.
Treatment Details
| Treatment | 8 porcelain restorations — combination of crowns and veneers |
| Existing Dentistry | Aged and stained composite bonding with disproportionate anterior tooth shapes |
| Esthetic Correction | Dental midline correction, improved anterior proportions and minor alignment correction |
| Ceramic | Layered E.max |
| Final Shade | BL2 MT |
| Gingival Treatment | Esthetic gingivectomy / gingival recontouring |
| Smile Design | SmileCloud |
| Restorative Design | exocad |
| Laboratory | Definitive ceramics completed in collaboration with a master laboratory technician |
| Appointments | 3 — consultation and digital smile planning, preparation with temporary smile design, and final delivery approximately two weeks later |
The Transformation
A direct comparison of the patient’s original smile and the completed result.
The Final Result
The completed smile is brighter, more symmetrical and better proportioned. Correcting the dental midline and replacing the old, stained composite bonding helped create a more balanced foundation for the overall transformation.
Eight layered E.max restorations were used in a combination of porcelain veneers and crowns, with a final shade of BL2 MT. The definitive ceramics were completed in collaboration with a master laboratory technician, combining the precision of digital planning with individualized layered ceramic characterization.
By addressing the midline, old composite bonding, tooth color, shape, minor alignment discrepancies and gingival architecture together, the final result creates a more cohesive relationship between the teeth, gums and overall smile.
Considering Porcelain Veneers in Newport Beach?
Whether you are unhappy with old bonding, tooth proportions, discoloration, alignment or the overall balance of your smile, every case requires an individualized approach. A cosmetic consultation at Newport Beach Dental Studio allows us to evaluate your smile and determine which treatment options may be appropriate for your goals.