The case presented below is for a 26-year-old male patient. He had multiple spacing in his maxillary anterior segment and short lateral incisors also had problem in occlusion with open bite.
The treatment options for such case would be orthodontic treatment (i.e., which is the ideal treatment option), indirect restorative approach, and the direct one . After discussing the treatment options, he chose the direct approach (close space with direct composite ) because of financial purpose and duration for this treatment .
To improve the length/width ratio of the teeth, diagnostic study casts were made, and a wax-up of teeth was created according to a 2D smile design by me. After that, palatal silicone index was made.
The treatment steps were presented in the images below
1- initial situation
2-DSD (2D) was made to accurately distribute the distances between the teeth
3-Study cast was made by stone material
4-Wax up was made to get overview about outline and dimension between two central
5-Silicone index to build palatal shell
6-rubber dam ,sandblast and acid etch
7- 2 week recall with some correct and polishing