Indirect Smile makeover with Style Indiretto

An indirect smile makeover requires thorough treatment planning, the right technique, and also the selection of the right tools, including the preparation bur kit to provide the most suitable bur sequence. A good bur selection, such as the Style Indiretto kit by Intensiv, for all indirect restorations such as veneers, crowns and onlay/overlay restoration means no need for using extra burs. This single kit provides simplicity and flexibility by offering all the burs that are commonly used in indirect restorations. This article shows the step by step to an indirect smile makeover using the Style Indiretto kit.

style italiano styleitaliano intensiv burs styleINDIRETTO banner
style italiano styleitaliano intensiv burs styleINDIRETTO banner
styleitaliano style italiano old defective restorations

A young female patient came to the clinic complaining of the unpleasant aesthetics of her smile. She wanted to have a beautiful teeth and to smile with confidence.

styleitaliano style italiano esthetic defects in smile

Her smile presented a few esthetic issues ranging from midline deviation, uneven gingival display during smile, and defective old restorations.

styleitaliano style italiano intraoral view of old unpleasant restorations

This retracted view shows the patient was missing her upper right canine, and had a defective porcelainfused-to-metal (PFM) bridge on the left side. She also had old composite veneers on the remaining anterior teeth.

styleitaliano style italiano highlights of esthetic issues to be corrected

The black contrasted view shows the discrepancies between right and left side, lacking symmetry in tooth to tooth proportions, gingival level and teeth long axis.

styleitaliano style italiano digital smile design

Simulation the final result by DSD. After discussing the treatment with the patient we decided to proceed as follows:
1- Correction of the gingival asymmetry by crown lengthening, to achieve a symmetric pink contour.
2- Removal of old PFM bridge
3- E-max crown restorations

styleitaliano style italiano stitches after crown lengthening

First, crown lengthening surgery was performed and the gingiva was left to heal.

styleitaliano style italiano teeth after removal of old bridge

After healing, the PFM bridge was removed.

styleitaliano style italiano teeth after removing old restorations

The old defective composite veneers were also removed before starting preparation.

styleitaliano style italiano waxed up model

A wax-up was done with the aim of simulating the final result through fabrication of a mock-up, which would also serve as the project for the fabrication of silicone indices as a guide during preparation.

styleitaliano style italiano silicone key try in

The wax-up-based silicone key was also used to quickly fabricate provisional restorations. During this step, remember to wait for the gel phase before removing the excess material.

styleitaliano style italiano mock up for minimally invasive preparation

With the aim of minimizing loss of tooth structure, preparation through the mock-up was chosen.

styleitaliano style italiano style indiretto intensiv bur kit

For the whole preparation, the Style Indiretto kit (Intensiv) was used.

style italiano styleitaliano intensiv burs styleINDIRETTO banner
style italiano styleitaliano intensiv burs styleINDIRETTO banner
styleitaliano style italiano style indiretto crown preparation sequence

Styleitaliano sequence for crown preparations:
STYC1 Palatal reduction
STYC2 Axial and incisal reduction
STYC3 Fine preparation

styleitaliano style italiano depth bur

Mock-up guided preparation starts with depth marker bur (optional).

styleitaliano style italiano depth guide grooves marked with pencil

Marking the depths with a pencil is very helpful in controlling the depth of the preparation to save sound tooth structure.

styleitaliano style italiano buccal reduction to calibrated depth

Labial reduction according the depth marks.

styleitaliano style italiano pick pack inserting retraction cord

After labial and proximal reduction and opening of the contact areas, we were ready to pack the retraction cords by using the PickPack instrument (Pascal).

pick pack banner pascale style italiano styleitaliano
pick pack banner pascale style italiano styleitaliano
styleitaliano style italiano subgingival abutment preparation

The preparations were completed by locating the cervical margin subgingivally.

styleitaliano style italiano palatal abutment refinement

Palatal reduction by using a large football diamond bur.

styleitaliano style italiano incisal and proximal preparation spacing check

After softening and smoothening the preparations by using the fine grain bur, we made sure we created enough incisal space for natural-looking final restorations.

styleitaliano style italiano checking buccal preparation spacing with silicone key

Also, buccal spacing was checked to follow the three labial planes.

styleitaliano style italiano prepared abutments with retraction cord

After finishing and polishing the final preparations.

styleitaliano style italiano double paste precision impression

The impression was taken with a double paste technique, using a soft putty and a light body to fill all the spaces created by the second retraction cord.

styleitaliano style italiano lithium disilicate crowns

Lithium disilicate (E-max) crowns were fabricated by the dental lab.

styleitaliano style italiano veneer me tool for lab work handling

Using Veneer Me is a must in my practice when handling lab work.

styleitaliano style italiano crowns on veneer me sticky pad

The first step of E-max bonding is etching by hydrofluoric acid for 20 seconds. Then the acid is rinsed out, and the surface of veneer is dried thoroughly.

styleitaliano style italiano crowns displayed onto the veneer me sticky pad

The next step is to apply a thin layer of silane and keep it 1-3 minutes. Then we apply the adhesive.

style italiano styleitaliano smileline veneer me
style italiano styleitaliano smileline veneer me
styleitaliano style italiano rubber dam isolation for adhesive cementation

Cementation under rubber dam is highly recommended for good bonding of the preparations and long-term bond stability.

styleitaliano style italiano crown cementation in progress with retracted rubber dam

Good retraction of the rubber dam can be achieved by B4 clamps.

styleitaliano style italiano lithium disilicate crowns after cementation

5 days after cementation, waiting for complete healing of the gingiva.

styleitaliano style italiano smile right after crown cementation

The final situation after correction of the gingival display, midline deviation and replacement of the old defective restorations.
The patient is very satisfied with result.

styleitaliano style italiano lithium disilicate crowns after healing

Two-month follow-up. You can see the complete healing of the gingiva, and the newly achieved symmetry.

styleitaliano style italiano smile with healthy gingiva after crown smile makeover

Full smile.


StyleItaliano protocols and tools, such as the Style Indiretto bur kit, provide dentists with the ultimate solution for quality practice, together with simplicity and flexibility.


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8.Tsirogiannis P, Reissmann DR, Heydecke G. Evaluation of the marginal fit of single-unit, complete-coverage ceramic restorations fabricated after digital and conventional impressions: A systematic review and meta-analysis. J Prosthet Dent 2016 Sep;116(3):328-335.e2.
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style italiano styleitaliano Essential Dentistry kit online on demand course
style italiano styleitaliano Essential Dentistry kit online on demand course


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styleitaliano style italiano Creation of a new smile

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