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Very nice work as always Ross!  


Is it me or does she have a canted smile line?

Nice work!

did you have touch up the prep after she healed from the perio surgery?

Very very good Ross. This is what happens when you educate yourself on the entire workflow of treatment. Your Spear education is more useful than your Cerec in this

Amazing result Ross.  Did you change the incisal position very much or was all of the length increase accomplished with crown lengthening?  I'm sure you addressed an implant for 9 with the patient, what was the thought process for choosing a bridge instead?  Cases with facial asymmetry can be very challenging and you handled it incredibly well.  Thanks for setting the bar so high!


It looks like she applied makeup and changed the color of her hair. You made a big difference on a lot of levels.

Incredible job! Made a huge difference. Nice work.

Very nice work Ross! When was time to do the finals, did you work out of models and pictures or did you do chairside?

She looks twenty years younger. Magic!

Did you do the gum surgery yourself as well?

Very well planned and executed.

Nice presentation as well.


Great case Ross.

Nicely done Ross!


Very nice!

I hate you!tongue

Excellent as usual Ross !  You showcase the integration of CEREC / digital technology with Spear concepts ver well - thank you for doing that.

Spear and Cerecdocs go very well together.  It's like cookies and milk happy!

Looking forward to next month's Live Patient Seminar and seeing similar cases and workflows.




Incredible! Hope you answer some of the questions posted here! I'm interested too. 


Nice Job :)


Great case presentation! Thanks for sharing!


Nicely done Ross.

As always, I appreciate the feedback and questions. Allow me to take a stab at answering them...

@James - She has an asymmetrical smile (patient's left side rises higher) and hypermobile upper lip (she has about 10-12 mm of dynamic movement). On top of that, we had some gingival rebound on the left side after the crown lengthening. I truthfully didn't pick it up until the final photos, but since the hard tissue was clearly adjusted by the periodontist to the correct level relative to my provisional crown margin, I should be able to do a touch-up gingivectomy to idealize the margin position and improve the left to right symmetry. Per your last question, I did not have to re-prep after healing since the tissue actually healed a little coronal to where I had planned it in the provisional/gingivectomy step.

@Daniel - I did not change the incisal position, so as you surmised, all the "length" came from the apical crown lengthening. As for the implant in #9, she opted against it because the incisive canal would have had to be enucleated and grafted. We instead did a connective tissue graft there to bulk up the pontic site and allow me to do a true ovate pontic design for #9.

@Rodrigo - Lab bench only with photos for reference. I'm glad to say there were zero fit issues or adjustments, but I did change the cusp position for #6 and 11 by adjusting intraorally prior to final seating. I also did the final glaze chairside after try-in because I found it very tricky to get the correct amount of lavender/grey tint on this very opaque BL2 LT substrate.

@Karen - I did not perform the crown lengthening in this case, although sometimes I do. I anticipated needing the connective tissue graft to bulk up the ovate site #9, so I sent her to my favorite periodontist to do that and the crown lengthening. He did a nice job, but we did get some rebound on the left side, as I mentioned before. It should be easily correctable, though with a little trimming.


Awesome! not worthy


Thanks Ross for sharing and answering our ?s