smile designing surgery

Smile Designing | Joshua Anthony

chief complaint


  • Known Smoker – Generalised yellowish discoloration noted.

Dental History

  • Was advised orthodontic treatment followed by implants by an earlier dentist was unwilling due to the cost and duration of treatment.

Extraoral Examination

extraoral examination

  • Thin upper lip.
  • Low smile line.
  • Midline shift.
  • Congenitally missing lateral incisors.
  • Canines in place of lateral incisors.
  • Retained deciduous canine (63).

social smile

duchennes smile

smile study

smile line

Intraoral Examination


Treatment Plan

treatment plan

  • Endodontic therapy for 14-24.
  • Extraction of 53.
  • All ceramic bridges across 14-24.

Extraction of Retained Deciduous Canine (63)

retained deciduous canine


Crown Preparations Done IRT 14-24 (All Ceramic Preps)

crown preparation

prosthetic planning

proposed shade

wax up

CAD images

CAD designing

post surgery smile

Temporary Bridge

temporary bridge

Bad Post OP Pictures

Camera Issues

  • Looked highly aesthetic in person.

bad post op

post op bad

post op picture

post bad op

post op image

smile design op

Before After Comparision

initial shade b2

pre op smile

post op smile

facial dental midline

correct dental midline

midline discrepancy

A shift in the dental midline would cause a misalignment with the interdental papilla. It would appear unaesthetic during a strained smile.

after smile design


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