The number of units required in an aesthetic case is determined by the extent of the visible dentition during function, not by the patient’s initial expectation or by budget.
Determining the aesthetic zone
The zone requiring treatment is established by observing the dentition displayed during a natural smile and during speech, which frequently extends further posteriorly than patients anticipate.
In a high smile line the first premolars and occasionally the second premolars enter the display zone. Restoring only the six anterior teeth in such cases produces a visible discontinuity in shade and contour at the canine.
The consequences of undertreating
Where restorations terminate within the visible zone, the transition between restored and unrestored teeth is perceptible under most lighting conditions, and becomes more so as the natural teeth darken with age while the ceramic does not.
This is the most common reason for patients returning dissatisfied from treatment that was technically well executed.
The consequences of overtreating
Preparing sound teeth outside the display zone provides no aesthetic benefit while incurring irreversible biological cost. Extending treatment for symmetry alone is not a defensible indication.
Typical distributions
Eight to ten upper units is the most frequent finding in cases with a moderate to high smile line. Six units is appropriate where display is limited. Cases requiring twelve or more units generally involve full-mouth considerations rather than purely aesthetic ones.
The unit count should be established from photographic and video analysis of the smile at the diagnostic stage, and stated in the treatment plan before any fee is agreed.
To determine whether this procedure is indicated in your particular case, we invite you to request a clinical assessment.
