Hindawi Publishing Corporation International Journal of Dentistry Volume 2011, Article ID 183471, 5 pages doi:10.1155/2011/183471 Case Report A Geriatric Patient: Age Is Not a Factor Lisa Klodnitskaya,1 Michele M. Harutunian,2 Santiago Mareque Buenos,3, 4 Denise Estafan,2 and Mark S. Wolff2 1 Maimonides Hospital, Brooklyn, NY 11219, USA 2 Department of Cariology and Comprehensive Care, NYU College of Dentistry, New York, NY 10010, USA 3 Department of Periodontology, University of Santiago de Compostela, Santiago de Compostela, Spain 4 Department of Periodontology, Universidad de Catalana, Barcelona, Spain Correspondence should be addressed to Michele M. Harutunian, mmh10@nyu.edu Received 17 March 2011; Accepted 19 April 2011 Academic Editor: Ali I. Abdalla Copyright © 2011 Lisa Klodnitskaya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. A patient presented to the dental oﬃce expressing dissatisfaction with the appearance of his teeth, and as a result, of his smile. Our objective was to satisfy his initial chief complaint: “I don’t like how my teeth look when I smile.” Methodology. Upon completing all initial exams and consultations, an esthetic dental treatment plan was formulated and agreed upon by both the practitioners and the patient. Results. The patient received periodontal treatment ﬁrst to create esthetic gingival margins. Anterior ceramic crowns followed. Conclusion. The results surpassed all patient’s expectations. 1. Introduction Correction of pathological migration of anterior teeth can be a daunting and frustrating endeavor for any dentists. Dif- ferent treatment alternatives are available to close the space between natural and artiﬁcial dentition. Such treatments range from simple composite restorations, periodontal ther- apy, veneers, and crowns to orthodontic realignment. This presentation is a patient who presented to our oﬃce expressing dissatisfaction with the gaps and color of his teeth, unhappy with the appearance of his smile. The objective of our treatment was to satisfy his initial complaint:“ I don’t like how my teeth look when I smile.” Upon completion of the initial examinations and necessary specialty consultations, an esthetic treatment plan was formulated and agreed upon by both the practitioners and the patient. The patient initially received periodontal treatment to create esthetic gingival margins. Anterior porcelain crown fabrication followed. The esthetic outcome of therapy surpassed all patient expecta- tions. 2. Case Presentation 2.1. Chief Complaint. A 60-year-old male patient presented for a routine “dental check-up.” He immediately expressed his chief complaint: “I don’t like how my teeth look when I smile.” He presented to our oﬃce with dental uncertainty and low self-esteem, a patient who never made eye contact while speaking softly and negatively about his unaesthetic smile. He presented with dark discolored teeth with clinical in- dications of occlusal wear. Immediately noticeable was the mismatch of his anterior crowns with his natural teeth, fa- ulty, restorations throughout his mouth, and a reverse smile line (Figure 1). A reverse smile line is present as the incisal edges of the posterior teeth in the lateral portion of the smile are lower than those of the anterior teeth. The incisal edge contours of the anterior teeth do not follow the lower lip in the smile. He was anxious to address the unaesthetic appearance of his anterior teeth as soon as possible, and he also wanted to take advantage of this opportunity to close the spaces between his teeth and whiten his smile. 3. Medical and Dental History 3.1. Findings. A comprehensive examination and review of the patient’s medical history showed him to be in overall good health, with no abnormal ﬁndings. Nothing in his past medical history was relevant to any dental treatment. He was