Fig.1
A young female patient presented with esthetic concerns related to the peg-shaped appearance of her lateral incisors. Clinical examination revealed conoid lateral incisors (#12 and #22) associated with diastemas. Upon closer inspection, the central incisors appeared misaligned, with tooth #21 showing a palatal torque, and both centrals exhibiting localized white spot lesions.
To achieve the optimal esthetic outcome, the initial treatment plan included:

• Orthodontic alignment of the central incisors
• Vital home bleaching of both arches
• Resin infiltration for the central incisors
• Direct composite veneers for the lateral incisors

However, the patient declined orthodontic treatment. The plan was consequently revised to:

• Bleaching
• Resin infiltration
• Composite veneers on #12, #21, and #22

Ultimately, the patient expressed satisfaction with the appearance of her central incisors and white spots, requesting only the closure of diastemas and reshaping of the lateral incisors. Although not the ideal comprehensive approach, this conservative plan aligned with her esthetic expectations.
The final treatment objective was therefore limited to the placement of two direct composite veneers on #12 and #22 to correct tooth shape, achieve proportional harmony, and enhance the overall smile balance.
The image demonstrates the peg-shaped lateral incisors, the misaligned #21 with palatal inclination, and the presence of white spot lesions on #11 and #21.

Fig.2
The intraoral photograph reveals the conoid morphology of the lateral incisors (#12 and #22), the palatal torque and slight misalignment of tooth #21, and the presence of white spot lesions on the labial surfaces of both central incisors (#11 and #21).

Fig.3
The intraoral photograph of the second sextant highlights the morphology and alignment of the lateral and central incisors, providing a detailed view of the clinical situation prior to restorative intervention.

Fig.4
Isolation of the operative field using a rubber dam to ensure a fully controlled environment and maintain optimal cleanliness during the procedure.

Fig.5
Sandblasting was performed to clean the surfaces and promote optimal bonding.

Fig.6
Bonding protocol: sequential application of sandblasting, etching, and adhesive bonding.

Fig.7
Dentin core built with an opaque composite using an anatomical stratification technique.

Fig.8
Detail of various tints applied to achieve a more natural shade.

Fig.9
Dentin core with some tints.

Fig.10
After placing a high-value enamel layer, the restoration is built sequentially: first, the primary anatomy and shape; next, the secondary anatomy; and finally, the tertiary anatomy, depending on the desired intensity.

Fig.11
Primary, secondary, and tertiary anatomy were also performed on tooth #12.

Fig.12
Before removing the rubber dam, the surface gloss achieved after proper polishing is visible.

Fig.13
Detail of tooth #22 after polishing, showing a high-gloss surface.

Fig.14
Detail of tooth #12 after polishing, showing a high-gloss surface.

Fig.15
Immediate post-operative result with a full smile. A pleasing tooth display and harmonious proportions are observed, with shapes aligned to the adjacent teeth. Final shade evaluation will be performed at the follow-up appointment after tooth rehydration.

Fig.16
Extraoral photo at the follow-up appointment. The patient is very satisfied with her new smile. Natural appearance, harmonious proportions, well-shaped teeth, and excellent color integration are evident. Chroma and value match the smile, confirming a successful outcome.

Fig.17
Intraoral photo on the control appointment.

Fig.18
Intraoral photo of the anterior second sextant.

Fig.19
3/4 Left, front and 3/4 right extra oral photos from the initial and final situation.

Conclusions

Beautiful results can be achieved in young patients using minimally invasive techniques, while preserving as much healthy tooth structure as possible.
A precise diagnosis and a well-structured treatment plan are essential. In terms of aesthetics, however, it is equally important to listen to the patients, allowing them the opportunity and responsibility to choose the treatment they wish to undergo. Understanding patients’ needs, goals, expectations, and personalities contributes to a relaxed and successful clinical practice. As the saying goes, “happy patient, happy dentist.”
Careful observation of the tooth’s optical properties is crucial. This includes evaluating enamel translucency and value, the dentin core, and internal effects on the incisal edge, without losing focus on the overall shape, which remains the main objective.
Once the tooth has been analyzed, the layering concept and appropriate composite system should be applied with precision. Keep the approach as simple as possible and enjoy the process, excellence is achieved through both skill and passion.

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