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Objective: This case report describes the treatment of a female patient with a median diastema, caused by tongue-tie and a tongue thrusting habit, using a sequence of multidisciplinary treatments to achieve an esthetic outcome.
Materials and procedures: A treatment plan was developed to first perform a frenectomy at the lower lingual frenum to correct the tongue-tie and utilize a removable orthodontic appliance with tongue cribs to train the patient’s swallowing habit. An asymmetrical gingival line was visible when the patient smiled. To evaluate the desired gingival level and the proportions of the restorations to be made based on the recurring esthetic dental (RED) proportion, a diagnostic wax-up model was fabricated. Esthetic crown lengthening was performed to correct the gingival line. Home whitening was prescribed for 2 weeks, with an additional 2-week waiting period to ensure tooth color stability. Final restoration was obtained by placing ceramic veneers on the maxillary anterior teeth.
Conclusions: This multidisciplinary treatment approach achieved excellent esthetic results; after veneer cementation, the patient exhibited greater confidence with her new smile.
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