A 23-year-old man wanted to improve the appearance of his smile. His upper front teeth were healthy and well aligned, but they appeared short and rounded, with noticeable spaces between them.
This distinction mattered. The objective was not to repair heavily damaged teeth or hide severe misalignment. It was to improve proportion and close the spaces while preserving as much natural enamel as possible.
The published case was followed for more than 12 years—and the most important part of the treatment happened before the veneers were made.
Beginning with a reversible preview
The clinicians first created an additive wax-up from canine to canine. This planned the proposed tooth length, width, contour and relationship between the six visible front teeth.
The design was then transferred into the patient’s mouth as a temporary mock-up.
This allowed the patient and clinical team to assess the new smile before any irreversible preparation. They evaluated:
- Tooth size and proportion
- The position of each tooth
- Surface shape and texture
- The relationship with the lips and surrounding smile
- The way the upper and lower teeth met during biting
Only after the patient and clinicians approved the mock-up did treatment continue.
Choosing between composite and porcelain
Direct composite bonding and ceramic veneers were both considered. Composite could have closed the spaces conservatively, while feldspathic porcelain offered highly natural optical properties and greater long-term colour stability.
Thin feldspathic veneers were selected because the teeth were already aligned and most of the desired change could be created by adding volume.
Preparation was restricted primarily to enamel. In the cervical area, approximately 0.2 mm was removed, while other areas required only minimal smoothing and adjustment. The final veneers were extremely thin, with some sections measuring less than 0.5 mm.
Preserving enamel created a favourable surface for adhesive bonding and avoided the aggressive reduction associated with full crowns.
The result after more than 12 years
During more than 12 years of clinical follow-up, the researchers reported no functional or aesthetic complications and no need for repairs.
There was no secondary decay, pulp inflammation, pulp death or postoperative sensitivity. A small amount of marginal staining appeared in certain areas, primarily associated with the natural movement of the gum line over time, but it did not compromise the overall result.
At the final follow-up, both the patient and clinicians remained highly satisfied.
The real lesson is not simply “veneers last”
The success of this case cannot be attributed to porcelain alone.
The patient had favourable tooth alignment, the planned changes were primarily additive, the final design was tested with a mock-up, and preparation remained almost entirely within enamel. The bonding and bite were also carefully controlled.
A patient with severe discolouration, extensive restorations, active gum disease, significant misalignment or uncontrolled teeth grinding may require a completely different approach.
The strongest part of this case was not how dramatically the teeth were changed. It was how little healthy tooth structure needed to be removed to achieve the desired result.
Good cosmetic dentistry should not begin with drilling. It should begin with diagnosis, design and a clear understanding of what can safely be preserved.
Published case reviewed: Reis et al., “Minimally Invasive Ceramic Laminate Veneers for Maxillary Anterior Esthetic Rehabilitation: A 12+ Years Follow-Up,” Journal of Esthetic and Restorative Dentistry, 2025. Treatment suitability and longevity vary between patients.
