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Open Access
CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0045-1812109
Case Report

Digitally Driven Interdisciplinary Smile Redesign in a Patient with Midline Deviation: A Case Report

Authors

  • Ruri Nur Alinda

    1   Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia

  • Putu Indra

    2   Smile Cloud Dental Clinic, Surabaya, East Java, Indonesia

  • Ferdinand Hadinata 

    3   Faculty of Dentistry, Petra Christian University, Surabaya, Jawa Timur, Indonesia

  • Made Dwiandri Satyaputra

    2   Smile Cloud Dental Clinic, Surabaya, East Java, Indonesia

  • Aulia Ayub 

    1   Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia

  • Ananto Ali Alhasyimi 

    1   Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia

Funding This paper was funded by Ministry of Finance Republic of Indonesia through Lembaga Pengelola Dana Pendidikan (Grant No. SKBP- 930/LPDP/LPDP.3/2024).
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Abstract

A 29-year-old woman with midline deviation (maxillary dental midline was shifted 4.3 mm to the right side) and unsightly anterior veneers placed by an unlicensed dental professional, resulting in poor esthetic outcomes. Clinical findings included incorrect occlusion, asymmetric gingival contours, and overcontoured veneers. A multidisciplinary treatment strategy was created to rectify midline deviation and restore esthetics. This included the expertise of orthodontists, periodontists, endodontists, and restorative professionals. The patient underwent a series of treatments, starting with orthodontic realignment to correct occlusion and midline deviation, followed by periodontal intervention to address asymmetric gingival contours, and finally, restorative procedures involving facially directed zirconia veneers. Posttreatment, the dental midline was realigned toward the facial flow line, significantly improving smile symmetry and occlusal function. The patient reported high satisfaction with the outcome, particularly regarding the harmony between her dental and facial features. This case highlights the effectiveness of a digitally driven, interdisciplinary approach to correct complex esthetic issues following poor dental restorations. Three-dimensional facial scanning, in combination with orthodontic, periodontal, endodontic, and restorative treatments, provided precise and predictable results, leading to a highly successful outcome and improved patient satisfaction.

Key Points

This technique has the following advantages:

  • Enables facially guided planning by integrating 3D facial and intraoral scans for natural smile harmony.

  • Improves precision and efficiency in crown lengthening using digital mock-ups and temporary crowns as surgical guides.

  • Supports minimally invasive veneer placement with accurate fit and better esthetics through a fully digital workflow.

Keywords

3D facial scan - midline deviation - crown lengthening - interdisciplinary dentistry - patient satisfaction

Consent for Publication

Written informed consent for publication was obtained from the patient to publish all clinical data and accompanying images.




Publikationsverlauf

Artikel online veröffentlicht:
22. Oktober 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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