First Impressions: November 2013

George Freedman, DDS


In First Impressions George Freedman, DDS, gives readers a brief summary of products that have recently been introduced to dentistry, based on his clinical experience.

Visionaire Dental Shells

The technique for designing a functional and aesthetic anterior tooth set up for a complete venture has been difficult and elusive. The traditionally taught process was to (1) approximately demarcate the anterior incisal positions as dictated by the maxillary lip and (2) to pinpoint the oral commissures on a wax rim attached to the base plate. The theory was that this information would be adequate for the laboratory technician to position the anterior denture teeth functionally and aesthetically; when the patient returned to the dentist several days later, the denture teeth mounted in the wax rims were tried in. Due to the inherent accuracy of the initial smile design on the wax rim, extensive adjustments were often necessary, including the complete resetting of both arches, sometimes requiring additional appointments. This inaccuracy and inefficiency was frustrating for both the patient and the practitioner. Dr. Joseph Massad developed Nobilium’s Visionaire Dental Shells as a single-piece, 8-tooth temporary aesthetic veneers used to rapidly preview the final smile design for a complete denture. Working together, the dentist and the patient design and agree upon the final aesthetic setup, including tooth shape and positioning. The Visionaire Dental Shells optimize occlusion, phonetics, aesthetics, and lip support. There are 3 sizes of dental shells (small, medium, large) and 4 mold forms that vary according to the patient’s vertical dimension of occlusion and facial form. The Visionaire Dental Shells are warmed in a water bath for 10 secondsand applied to the wax rim. The dentist can readily optimize the midline, the resting lip-line, the high smile lip-line, and the buccal-lingual positioning of the dentition. Visionaire Dental Shells improve the dentist-patient convergence, reduce resets and remakes, and eliminate practitioner stress.
For more information, call (800) 833-2343 or visit the Web site at

Dr. Freedman is a founder and past president of the American Academy of Cosmetic Dentistry, a co-founder of the Canadian Academy for Esthetic Dentistry, and a Diplomate of the American Board of Aesthetic Dentistry. He is a visiting professor at the Universita di Firenze, Florence, Italy. He is the materials editor for Dentistry Today. He is the author or co-author of 11 textbooks, including his most recent textbook Contemporary Esthetic Dentistry (Elsevier), more than 700 dental articles, and numerous webinars and CDs, and is a team member of REALITY. He lectures internationally on dental aesthetics, adhesion, desensitization, composites, impression materials, and porcelain veneers. A graduate of McGill University in Montreal, Dr. Freedman maintains a private practice limited to aesthetic dentistry in Toronto. He can be reached at (905) 513-9191 or