A smile makeover rebuilds the look of a smile by combining several treatments into one plan. Ahmad, a 33 year old man from Turkey, wanted a natural even smile but faced crowding and uneven gum levels with old fillings and caries over two incomplete root canals. Over a five day multidisciplinary process, the team leveled his gums and retreated failed root canals before placing 28 high strength zirconia crowns. This case study follows Ahmad’s smile makeover at International Plus, where over 200,000 patients from 140+ countries have been treated since 2014 and shows how careful sequencing turns a complex mouth into a confident smile.
Key Takeaways
- The challenge: Ahmad disliked his smile because of crowding and uneven gum levels, worsened by old restorations, caries and previously incomplete root canals.
- The solution: A staged smile makeover from gingivectomy to level the gums and root canal retreatment through to 28 high strength zirconia crowns in his preferred OM2 shade.
- Technical highlights: Gingivectomy on the six upper front teeth, retreatment of a half finished root canal on tooth 12 and a PMMA trial smile before the final crowns.
- The outcome: Crowding camouflaged, the gum line leveled and failed root canals redone for a natural, confident smile. Individual results may vary.
Ahmad’s Story: Unhappy With an Uneven Smile
Ahmad, a 33 year old man from Turkey, came to our clinic unhappy with the look of his smile. Ahmad described crowded looking upper teeth and gum lines that sat at uneven heights. Old restorations no longer matched the neighbouring teeth. Beneath the surface, the picture was more complex because Ahmad also had active caries and two front teeth with previously incomplete root canals. For Ahmad, the goal was a natural even smile in one specific shade, OM2 rather than an obviously artificial result, the same balance we describe in the truth about Turkey teeth. Aesthetic concerns like Ahmad’s are among the most common reasons adults seek treatment and structured smile analysis begins by mapping these problems (Sabbah et al., 2022). In our clinic, the team never starts cosmetic work before treating the health problems underneath because a new crown over an untreated tooth fails early. That principle shaped every stage of Ahmad’s plan.
Diagnosis and Treatment Plan: Health Before Aesthetics
Ahmad’s treatment plan set a clear order: treat disease first, then rebuild the smile with crowns. Examination and imaging confirmed crowding, uneven gingival levels on the six upper front teeth, caries under old fillings and two incomplete root canals on teeth 11 and 12. One of these, tooth 12, held a half finished root canal that had left infected tissue behind. The plan combined periodontal and endodontic steps with restorative work across roughly five days. Retreating an incomplete root canal to remove infected tissue measurably improves the long term outcome of the tooth (Sabeti et al., 2024). Our multidisciplinary team maps each tooth before any preparation, which is how the plan sequenced gum surgery and root canal work, then caries removal ahead of the aesthetic phase. For this reason, the order protected Ahmad’s foundation before a single crown was designed, the same discipline behind our multidisciplinary rehabilitation cases.
Leveling the Gums and Rebuilding the Foundation
Gingivectomy is a minor procedure that reshapes and evens the gum line. In Ahmad’s case, gingivectomy was performed on the six upper front teeth, teeth 13, 12, 11, 21, 22 and 23 to bring the gum heights into balance. Levelling the gingival margins before crown work is a well documented step in aesthetic cases (Qali et al., 2024). After the gum work came the foundation. Root canal treatment was carried out on teeth 11 and 12, where infection had formed lesions and the half finished canal on tooth 12 was retreated to clear the infected tissue. Old fillings and active caries were removed, then the teeth were prepared for crowns. Between the surgical and restorative stages, healing sessions gave the gums time to settle. The team also waits for gum maturation rather than rushing to crowns because gums that are still healing shift the final margin. That patience protected Ahmad’s gum line.
Designing Ahmad’s Smile Makeover: PMMA Trial to 28 Zirconia Crowns
The final smile makeover rebuilt Ahmad’s teeth with 28 high strength zirconia crowns in the OM2 shade he had chosen. Before the permanent crowns, Ahmad wore a PMMA trial smile, a set of provisional restorations in the planned shape, known in the clinic as the plastik prova. A trial smile lets the patient preview and approve the design before final ceramics are made (Garcia et al., 2018), the same step used in our couple full mouth zirconia case study. Details from digital smile design guided the tooth shape and proportions (Thomas et al., 2022), the same precision behind our golden smile design work. The zirconia crowns then camouflaged the crowding and corrected the aesthetic mismatch between the upper and lower teeth. Monolithic zirconia shows strong documented survival in clinical reviews (Leitão et al., 2022), comparable to older metal ceramic crowns (Pjetursson et al., 2018). In our practice, the team confirms the trial smile in the mouth before milling because a preview on screen cannot replace how teeth look on a real face.
| Stage | Focus | What was done |
| Gum leveling | Periodontal | Gingivectomy on teeth 13 to 23 to even the gum line |
| Foundation | Endodontic and restorative | Root canals on teeth 11 and 12, retreatment of tooth 12, caries and old fillings removed |
| Trial smile | Aesthetic preview | PMMA provisional (plastik prova) approved before the final crowns |
| Final restorations | Prosthetic | 28 high strength zirconia crowns in the OM2 shade |
Considering a smile makeover? You can ask our clinical team for an assessment directly on WhatsApp.
The Result: A Natural, Confident Smile
Ahmad finished the roughly five day process with a smile that looked natural rather than obviously restored. The crowding was camouflaged and the gum line levelled while the previously failed root canals were redone so Ahmad left with both health and aesthetics addressed. The OM2 shade gave a bright but believable colour that suited Ahmad’s face, an approach we also apply in wider Hollywood smile cases. As with every case we publish, individual results may vary and a personal consultation is the only way to know what a smile makeover can achieve for you as our ultimate guide to the smile makeover explains. This outcome reflects the standard behind International Plus: official Ministry of Health authorization and 5,504+ verified reviews at 4.8/5 with 200,000+ international patients treated since 2014. That combination is why a complex smile makeover like Ahmad’s can be sequenced safely, treating disease first and rebuilding the smile only once the foundation is sound.
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Frequently Asked Questions
What is a smile makeover?
A smile makeover is a personalized plan that combines several dental treatments to improve how a smile looks. It may include gum contouring, root canal treatment, caries removal and crowns or veneers. The aim is a natural, balanced result so any underlying disease is treated before the aesthetic work begins.
Can a smile makeover fix crowded teeth without braces?
In suitable cases, yes. When a patient prefers not to have braces, mild to moderate crowding can often be camouflaged with crowns or veneers designed over prepared teeth. A full clinical and radiographic examination decides whether this route is appropriate since some cases still need orthodontic alignment first.
Why level the gums before placing crowns?
Uneven gum heights make even well made crowns look unbalanced. Gingivectomy reshapes the gum line so the visible tooth lengths match across the smile. Levelling the gums first, then allowing them to heal, lets the final crown margins sit correctly, which is why gum work usually comes before the restorative stage.
What is a PMMA trial smile?
A PMMA trial smile, sometimes called a plastik prova, is a set of temporary provisional restorations worn before the final crowns are made. It lets the patient preview the shape, length and shade of the planned teeth and request changes. The final zirconia crowns are only produced once the trial design is approved.
Reviewed by Dr. Abdurrahim Ulu
References
- Sabbah A, et al. Smile Analysis: Diagnosis and Treatment Planning. Dent Clin North Am. 2022. PMID 35738730
- Qali M, et al. Clinical Considerations for Crown Lengthening: A Comprehensive Review. Cureus. 2024. PMC11614317
- Sabeti M, et al. Outcome of Contemporary Nonsurgical Endodontic Retreatment: A Systematic Review. J Endod. 2024. PMID 38280514
- Garcia PP, et al. Digital smile design and mock-up technique for esthetic treatment planning. J Conserv Dent. 2018. PMC6080190
- Thomas PA, et al. Digital Smile Design. J Pharm Bioallied Sci. 2022. PMC9469272
- 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
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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.
