Do you like surprises? You may ask--"What kind of surprises?" Well, imagine that you have booked the whole afternoon for one of your patients who came today for the final insertion of 10 maxillary restorations. The case just arrived from your laboratory and you did not have enough time to look at it and you are not quite sure what to expect because every time something comes from the lab it is a true surprise! You slowly start approaching the surprise box and half way through you get a brilliant idea, and ask your assistant to have a look at it first - like this would change anything! She opens the box looks at the case and says, "It looks good!"

You start trying the case in and a cold and then hot sensation passes through your body because you notice that the whole case has a severe canting, as well as there is something odd in the shape of the restorations. If that is not enough, two of the veneers do not fit. Surly the case is' No Go'. How did this happen?

One month ago your patient made a decision to invest in her smile and, attracted by the big sign above your office stating "General and Cosmetic Dentistry" as well as her long time patronage of your office, she has chosen you to enhance her smile. The final impressions and a c/o bite registration were taken and sent to the lab with a prescription stating " please fabricate all ceramic restorations for teeth 1.5-2.5. Shade A1". At the lab all of the information was put together to fabricate 10 all ceramic restorations and sent back to the office in the "surprise box."

Cosmetic dentistry is an area of practice that combines the skills of the dentist, dental technician and all the auxiliaries of the practice. Like good operative dental practices, consistently good results come from consistently good record taking (Fig. 1), diagnosis and treatment planning. What arrives from the lab should not be a 'surprise box'; the team needs to have a high degree of confidence about what is inside so that the delivery appointment runs as smoothly as possible. It should contain exactly what is required to bring the treatment phase to a successful conclusion. This is only possible with good communication.

In order to ensure predictable results, a common protocol in the form of checklists must be created. That protocol has to have established, open channels of communication by means of verbal dialog, written notes (Fig. 6) as well as visual and mechanical aids between the patient, dentist and the laboratory or better yet, the technician working on the case.

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