 A successful smile makeover is not simply a collection of attractive crowns or veneers. It is a carefully planned rehabilitation in which facial aesthetics, tooth proportions, preparation design, material selection, occlusion and laboratory communication all need to work together. When a case is planned well, the final restorations should feel like the natural conclusion of a process already tested through the diagnostic wax-up and provisional stage. When planning is rushed, the laboratory is often left trying to solve clinical uncertainties after the teeth have been prepared. That is when compromises, adjustments, remakes and difficult patient conversations begin. At Bremadent Dental Laboratory, we approach a smile makeover as one connected workflow. The preoperative records influence the diagnostic design. The design guides the preparations. The provisionals test the proposal. The approved provisional result then becomes a valuable reference for the definitive restorations. The ceramic work may receive the compliments, but predictability is usually created much earlier. What Is a Smile Makeover?
A smile makeover uses restorative treatment to improve the appearance of the teeth visible during smiling, speaking and normal facial expression. Depending on the patient, treatment may involve veneers, crowns, onlays, composite restorations, implants, orthodontics, periodontal treatment or a combination of these. The correct question is not, “How many teeth should we crown?” It is, “What needs to change, and what is the most conservative way to achieve it?” The treatment plan may need to address:
The Aesthetic Zone and the Functional Zone The aesthetic zone includes the teeth and supporting tissues visible during smiling and facial movement. It is patient-specific. A patient with a broad, high smile line may display premolars and gingival tissues, while another patient may show only the upper anterior teeth. This means the aesthetic zone cannot be defined from a model alone. The laboratory needs facial and smile information to understand what the patient actually displays. The functional zone is equally important. It includes the surfaces and contacts responsible for guidance, load distribution and occlusal stability. In many cases, the same anterior teeth sit within both zones. They must look natural while also managing protrusive and lateral movements appropriately. A common planning mistake is to treat these zones separately. Beautiful anterior restorations can still fail if they are repeatedly overloaded. Strong posterior restorations can still create problems if their contours, contacts or occlusion interfere with function. A successful smile makeover therefore needs to balance:
The Smile Line Is More Than the Teeth Visible in a Photograph The smile line describes how the incisal edges of the upper teeth relate to the curvature of the lower lip. In a harmonious smile, the upper incisal curve generally follows the lower lip without appearing excessively flat, reversed or artificial. However, the smile line cannot be assessed reliably from one retracted photograph. Patients do not walk around with cheek retractors in place. Useful records include:
The laboratory also needs to know whether the intended incisal plane should follow the interpupillary line, the lower lip or another facial reference. These lines are not always perfectly parallel. If there is a facial asymmetry or occlusal cant, it is better to discuss it before manufacturing the final restorations than discover it at the fit appointment. Understanding Golden Proportion Without Designing by Calculator The golden proportion is often discussed in cosmetic dentistry as though it provides a universal formula for the perfect smile. In simplified terms, it suggests that the visible width of each tooth reduces in a particular proportion as the teeth move distally from the central incisors. It can be a useful reference, but it should not become a rigid rule. Apparent tooth width is affected by arch form, tooth rotation, viewing angle, buccal corridor, facial shape and the position of the patient’s lips. Two teeth with identical physical widths can appear very different from the front. When planning tooth proportions, we consider:
The goal is not mathematical perfection. It is a balanced result that belongs to the patient. Why the Diagnostic Wax-Up Is the Foundation of the Case A diagnostic wax-up converts the treatment plan into a three-dimensional proposal. It allows the clinician, technician and patient to examine the intended tooth position, length, shape and occlusion before irreversible treatment begins. At Bremadent, diagnostic wax-ups can be produced conventionally or through a digital workflow, depending on the case and records provided. Accurate study models can also be anatomically mounted using a suitable facebow and articulator record when the complexity of the case justifies it. A properly prescribed wax-up can help assess:
The best wax-ups begin with a clear prescription and end with clinical validation. How a Mock-Up Improves Consent and Case Acceptance A matrix made from the diagnostic wax-up allows the proposed design to be transferred into the mouth using a suitable provisional or mock-up material. The patient can then see and feel the approximate planned result. This is valuable because patients often struggle to interpret photographs, drawings or a model held in front of them. Once the design is in the mouth, they can assess tooth display, length, speech and overall character more meaningfully. During the mock-up appointment, check:
A patient saying “yes” to a stone model is useful. A patient approving the design in their own mouth is considerably more useful. Preoperative Records: What the Laboratory Needs The quality of the laboratory result is directly related to the quality of the information received. A beautiful photograph cannot compensate for a distorted impression, and a perfect scan cannot tell us where the patient’s facial midline sits unless the relevant facial records are also supplied. For a comprehensive smile makeover, the ideal information includes:
This is why we often recommend matrixing or scanning the existing dentition before treatment, even when the existing teeth are far from ideal. Digital Scans: Accurate, Efficient and Not Infallible Intraoral scanning can reduce several variables associated with conventional impressions. Scan data can be transferred directly into the CAD workflow, allowing the laboratory to inspect preparations, margins, occlusal clearance and adjacent anatomy without pouring a conventional model first. Digital scans are especially useful for:
Digital does not mean automatic. It simply gives us a different set of variables to control. Conventional Impressions: Still Valuable When Taken Properly A high-quality conventional impression remains an excellent clinical record. It can capture multiple preparations accurately when moisture control, tray selection, material handling and tissue displacement are managed correctly. The most common problems are familiar:
Whether the case arrives digitally or conventionally, the objective is the same: complete, undistorted information with visible margins and a dependable occlusal relationship. Reduction Guides Protect Tooth Tissue and Ceramic Space A reduction guide is produced from the approved diagnostic wax-up and helps the clinician compare the preparation with the intended final contour. Without a guide, reduction is judged mainly against the existing tooth. This can be misleading when the planned restoration changes tooth position or adds volume. A protrusive tooth may require more reduction in one area, while a retruded or undersized tooth may require very little. Useful guide designs include:
Under-reduction may produce bulky restorations, poor emergence profiles or opaque-looking ceramics. Over-reduction sacrifices tooth tissue, weakens the preparation and may compromise bonding. A guide helps the clinician find the controlled middle ground. Provisional Stents and the Provisional Trial Period A provisional stent or matrix transfers the wax-up into the mouth after preparation. Well-made provisionals do more than protect the preparations. They act as a functional prototype for the final case. The provisional stage can test:
The definitive restorations should not be the first time the proposed design is tested in the mouth. Matrixing the Existing Teeth Preserves Useful Information Before preparing the teeth, an index of the existing dentition can preserve the original incisal position, palatal anatomy, tooth volume and occlusal contacts. This is particularly useful where the patient likes aspects of their current smile or where the existing anterior guidance is functioning well. Preoperative matrixing may involve:
Not every existing contour should be copied. Equally, not every contour should be discarded simply because the patient is having a smile makeover. IPS e.max for Anterior Restorations IPS e.max is a lithium disilicate ceramic widely used for veneers, anterior crowns, inlays, onlays and selected other restorations. Its optical properties make it particularly valuable in the aesthetic zone, where translucency, light transmission and natural character are important. Depending on the clinical situation and laboratory design, e.max can provide:
Preparation design, ceramic thickness, selected ingot or block, cement shade and surface character all affect the outcome. E.max is not automatically aesthetic simply because it is tooth-coloured. The result depends on how the entire system is planned and executed. Why Zirconia Is Often Selected Posteriorly Zirconia is commonly selected for posterior crowns and bridges because it offers high strength and can be designed monolithically, reducing reliance on a veneering layer in high-load areas. It is particularly useful where there is:
For posterior cases, contour and occlusion remain critical. A strong material does not protect an opposing tooth from an incorrectly adjusted or poorly polished surface. After occlusal adjustment, zirconia should be polished correctly rather than left rough. Combining e.max Anteriorly and Zirconia Posteriorly Using e.max in the anterior region and zirconia posteriorly can provide a sensible balance between aesthetics and strength. However, the transition between materials must be planned carefully. The laboratory needs to harmonise:
For demanding anterior cases, custom shade matching can help the technician assess internal effects, translucency, surface texture and value more accurately. Common Reasons Smile Makeover Cases Become Difficult Most complications are not caused by one dramatic mistake. They are usually the result of several small pieces of missing or inconsistent information. Common problems include:
A Predictable Smile Makeover Workflow A practical sequence for many cases is:
How Bremadent Supports Smile Makeover Cases At Bremadent Dental Laboratory in London, our smile makeover workflow can combine accurate study models, anatomical articulation, diagnostic wax-ups, reduction guides, provisional stents, digital design, custom shade information and a range of conventional and CAD/CAM restorations. We train our crown and bridge technicians to evaluate restorations beyond basic fit. Margins, contacts, occlusion, anatomy, surface texture, material thickness and aesthetics must all work together. For the best result, involve the laboratory before the preparation appointment. Early discussion allows us to identify missing records, potential space limitations, material conflicts and design considerations while changes are still straightforward. A smile makeover should not depend on hope, memory or a last-minute note written on the laboratory prescription. The more accurately the final outcome is planned, transferred, tested and communicated, the more predictable the clinical result becomes. "We provide a trusted laboratory service delivering consistent quality, saving chairside time, and supporting predictable patient outcomes." Do you want to discuss your next Smile Make Over Case? 📞: 0208 520 8528 📧: [email protected] 📍: 25A St James Street, London, E17 7PJ
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Private Dental Laboratory in London
 Kash Qureshi - Managing Director, Clinical Dental Technician
About the author:
Kash Qureshi is a Clinical Dental Technician (Denturist) in the U.K who oversees and quality controls over 3000+ fixed and removable prosthesis including implant cases from a clinical and technical aspect monthly at Bremadent Dental Laboratory & Swissedent Denture Clinic in London. www.swissedent.co.uk www.bremadent.co.uk [email protected] Categories
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