Most patients travel to Istanbul alone. Nikola and Pēteris, a couple who had spent years postponing their dental goals, decided to do it together. Both wanted a natural, confident smile yet their clinical situations could hardly have been more different. This case study follows how our team planned and delivered full mouth zirconia crowns for two people at the same time, using one fully digital workflow adapted to two very different starting points. Both treatments were completed at International Plus, where over 200,000 patients from 140+ countries have been treated since 2014.
Key Takeaways
- The challenge: Two patients, one journey. Nikola presented with pronounced crowding and a missing lateral incisor but declined orthodontic treatment; Pēteris presented with worn and discolored teeth plus failing older restorations.
- The solution: Full mouth zirconia restorations on natural teeth for both patients, planned through a shared digital workflow with individual treatment designs.
- Technical highlights: MetiSmile face scanning, 3Shape TRIOS digital impressions, multi stage PMMA trial smiles printed in house and high strength multilayer zirconia milled on Redon systems.
- The outcome: Both patients regained full chewing function and approved their final smiles before production; each left Istanbul satisfied with the result.
A Shared Decision: Why Nikola and Pēteris Came Together
Nikola and Pēteris arrived at our clinic as a couple with a shared goal: to stop being self conscious about their teeth. Traveling together made the process easier for both of them. They attended each other’s consultations and compared notes after every appointment, supporting one another through the treatment days in Istanbul.
Their motivations, however, were personal. Nikola’s main concern was the visible crowding in her smile and a missing lateral incisor that disturbed its symmetry. Pēteris was troubled by years of wear and discoloration along with older restorations that no longer looked natural, the kind of gradual damage we also document in severe wear and tooth loss rehabilitations. For an international couple planning treatment abroad, coordinated scheduling matters; our patient coordination team aligned both treatment plans so every clinical stage could run in parallel.
Diagnosis and Treatment Planning for Two Different Smiles
The diagnostic phase answered one question for each patient: what is the healthiest route to the smile they want? Panoramic radiographs and targeted periapical imaging confirmed that both Nikola and Pēteris had periodontally and endodontically sound abutment teeth, meaning their natural teeth could safely support full coverage zirconia restorations without implants.
Every plan of this scope at International Plus is reviewed by the Diagnostic Council, our multidisciplinary board where prosthetic, endodontic and restorative specialists evaluate the findings together, the same board behind our multidisciplinary rehabilitation cases. That shared review shaped two individual plans.
For Nikola, the central decision was orthodontic. She was first offered braces as the conservative option for her crowding but she did not want orthodontic treatment. The team therefore planned zirconia crowns over her natural teeth to correct the alignment visually in a much shorter time, a route similar to our crossbite correction case with zirconium restorations. Because of the pronounced crowding, selected teeth needed root canal treatment to allow an ideal preparation axis, an approach consistent with published guidance on restoring root filled teeth (Bhuva et al., 2021). Her missing lateral incisor was replaced within the design as a bridge pontic, restoring symmetry without surgery.
For Pēteris, the groundwork was restorative. Decayed areas and inadequate fillings were treated and his older restorations renewed first, creating a sound, predictable foundation before any crown preparation began. In both mouths, the health problems were solved before the aesthetic work started.
| Patient | Presenting concern | Preparatory work | Restorative solution |
| Nikola | Pronounced crowding, missing lateral incisor | Conservative care plus root canals for preparation axis | Full mouth zirconia crowns with a bridge pontic |
| Pēteris | Worn, discolored teeth, failing old restorations | Renewal of decayed and inadequate restorations | Full mouth zirconia crowns on natural teeth |
Bottom line: the same restorative concept solved two different problems because the preparatory work was tailored to each mouth.
Wondering which approach fits your smile? You can reach our team directly on WhatsApp for a personalized evaluation.
The Digital Workflow: From Face Scan to Trial Smile
Both treatments ran through the same fully digital full mouth workflow our clinic applies to every rehabilitation, which is what made treating a couple in parallel practical. Each stage produced measurable data and each design decision was confirmed by the patient before the next step.
Planning began with the SHINING 3D MetiSmile face scanner, which captures the facial anatomy in about 10 seconds at 50 micron detail. International Plus is the only clinic in Turkey using this system for smile design. It allowed the digital smile design for each patient to be built around their own facial lines and lip dynamics.
The midline and occlusal plane were planned digitally, together with tooth proportions and vertical dimension. The predictability of this design approach is well documented in the literature (Thomas et al., 2022). Shade selection followed the same logic: each patient’s skin tone and expectations guided a natural tone agreed before production.
After tooth preparation, which was kept as conservative as each clinical situation allowed, digital impressions were captured with the 3Shape TRIOS intraoral scanner. Compared with conventional impressions, intraoral scanning offers a comfortable and highly accurate record as confirmed in a systematic literature review (Kihara et al., 2020). In plain terms, neither patient needed trays of impression material; a small camera recorded everything.
The couple then entered the stage patients remember most: the PMMA trial smile. Multi stage provisional restorations were 3D printed on an Asiga MAX UV printer using Arma dental resin so Nikola and Pēteris could each wear a physical preview of their future teeth.
Each trial session checked appearance and speech, then lip support and the bite. Revisions continued until both patients approved their final design. Trial restorations of this kind are a well documented way to refine anterior aesthetics before committing to final ceramics (Garcia et al., 2018). This is the same “test drive your smile” philosophy behind our wider smile makeover work.
| Stage | Technology | What it delivered |
| Face scan | SHINING 3D MetiSmile | A smile design matched to each face |
| Digital impressions | 3Shape TRIOS scanner | Accurate records without impression trays |
| Trial smile | Asiga 3D printer with Arma PMMA resin | A wearable preview approved by each patient |
| Final production | Redon milling, multilayer zirconia | High resolution crowns from the in house lab |
Bottom line: every stage of the digital chain produced something each patient could see and approve before the final crowns were milled.
Producing and Delivering the Full Mouth Zirconia Crowns
Once each design was approved, production moved to our in house laboratory, where the approved digital files were milled from high strength multilayer zirconia blocks on Redon milling systems at high resolution. Keeping the laboratory inside the clinic gave the team full control over the fit and shade of every single unit for both patients at once.
Zirconia was chosen deliberately. For tooth supported restorations, monolithic CAD/CAM zirconia shows strong clinical performance in systematic reviews and meta analyses (Leitão et al., 2022) and zirconia ceramic crowns show survival comparable to the long standing metal ceramic standard (Pjetursson et al., 2018). Multilayer blocks add a natural color gradient from gum line to edge, which matters in a full smile reconstruction whether tooth supported or part of an advanced implant rehabilitation with zirconia restorations.
Before delivery, each set of restorations went through an intraoral try in. Marginal fit and aesthetic integration were verified in detail, followed by the occlusion, meaning how the upper and lower teeth meet. Fine adjustments were made until the restorations seated passively and comfortably. Only then were the full mouth zirconia crowns cemented with the appropriate protocol. Fully digital full mouth rehabilitations of this type are increasingly reported as a predictable treatment route in clinical literature (Luna-Domínguez et al., 2023). For both patients, the final check confirmed a natural appearance and a stable, functional bite.
The Result: Two Smiles, One Journey
Both patients finished treatment with restored chewing function and the aesthetic result they had approved in advance. Nikola’s crowding and missing lateral incisor were resolved without braces and Pēteris replaced years of wear and discoloration with a bright, uniform smile. Each received detailed guidance on oral hygiene and long term care of their restorations.
What made this case special was watching them experience it together. When Nikola saw her trial smile for the first time, it was Pēteris who reacted first. By the delivery appointments, they were photographing each other’s new smiles in the clinic. Both told our team they left satisfied with the result matching what they had approved on screen and in their trial smiles. You can read more patient journeys like Nataliia’s full mouth smile transformation in our case study archive. As with every case we publish, individual results may vary and a personalized consultation is the only way to know what is possible for your own smile.
Cases like this reflect the system behind the outcome: a Diagnostic Council that plans health first, plus a fully digital design chain the patient approves at every stage. Behind them stands an in house laboratory that controls quality to the last micron. That standard applies across all our dental treatments from a single crown to a double full mouth rehabilitation. International Plus combines official Ministry of Health authorization, 5,504+ verified Google reviews at 4.8/5, 200,000+ international patients and premium digital systems, which is why couples like Nikola and Pēteris can plan full mouth zirconia crowns in Istanbul with verifiable confidence.
Discover full mouth rehabilitation at International Plus → Book your free consultation
Frequently Asked Questions
What are full mouth zirconia crowns?
Full mouth zirconia crowns are full coverage ceramic restorations placed on the natural teeth of both jaws to rebuild their shape and color while correcting visible alignment. Made from high strength zirconia, they are used to restore worn or damaged teeth with a durable and natural looking fixed result.
Can zirconia crowns fix crooked teeth without braces?
In suitable cases, yes. When a patient declines orthodontic treatment, crowding can often be corrected visually with full coverage crowns designed over the natural teeth, sometimes supported by root canal treatment to align the preparation. A thorough clinical and radiographic examination determines whether this route is appropriate for you.
Can a couple have dental treatment together in Turkey?
Yes. Couples are increasingly common at international clinics and treatment plans can be scheduled in parallel so both partners share the same trip and the same recovery days. At International Plus, both patients receive coordination in 21 languages, with transfers and accommodation arranged within a single organized plan.
How long do zirconia crowns last?
Clinical studies report high survival rates for zirconia crowns with systematic reviews showing performance comparable to traditional metal ceramic restorations over five years and beyond. Longevity depends on oral hygiene and bite forces as well as regular checkups, which is why every patient receives a personalized maintenance plan after delivery.
What is a PMMA trial smile?
A PMMA trial smile is a set of 3D printed provisional restorations worn before the final ceramics are produced. It lets you preview the shape and feel of your future teeth in daily life and request revisions so the final full mouth zirconia crowns are only milled after you approve the design.
Reviewed by Dr. Eren Gülbahar
References
- Bhuva B, et al. The restoration of root filled teeth: a review of the clinical literature. Int Endod J. 2021. PMID 33128279
- Thomas PA, et al. Digital Smile Design. J Pharm Bioallied Sci. 2022. PMC9469272
- Kihara H, et al. Accuracy and practicality of intraoral scanner in dentistry: A literature review. J Prosthodont Res. 2020. PMID 31474576
- Garcia PP, et al. Digital smile design and mock-up technique for esthetic treatment planning. J Conserv Dent. 2018. PMC6080190
- Leitão CIMB, et al. Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis. J Prosthodont Res. 2022. PMID 34615842
- Pjetursson BE, et al. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res. 2018. PMID 30328190
- Luna-Domínguez CR, et al. Full mouth rehabilitation in a completely digital workflow using partially adhesive monolithic zirconia restorations. J Esthet Restor Dent. 2023. PMID 37026815
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This content is written, reviewed, and approved by the International Plus Medical Review Board to ensure clinical accuracy and adherence to strict editorial standards. All medical information is regularly monitored, audited and updated in light of the latest scientific advancements.
However the information provided here is for general informational purposes only and cannot be used for self diagnosis or making individual health interpretations. Results of medical treatments depend on individual anatomy and the unique healing process of each patient. This information should not replace a personal consultation with a qualified healthcare professional. To understand the best options for your specific needs and to receive a personalized treatment plan, we invite you to book a free consultation with the expert medical team at International Plus.
I am a healthcare professional with over 4 years of experience in dentistry, specializing in prosthetic dental treatment and implant-based applications. Since 2024, I have been serving as chief physician, leading clinical management, team coordination, and international patient processes. With my B2-level English proficiency, I am able to communicate effectively with international patients. I am a patient-centered, innovative, and solution-oriented dentist who prioritizes patient satisfaction.
