When more than braces are needed

Missing Lateral Incisors

 

As is common with many aspects of our lives, technology drives the changes that benefit us in numerous ways. In dentistry the advent of implant technology has made possible dramatic improvements in the esthetics of tooth replacement.

It is not an uncommon problem for the lateral incisor teeth to be missing in a young patient. Mother nature seems not to value these teeth as they are often missing or diminutive in size.

When they are missing, the canine teeth erupt so close to the central incisors as to prevent a normal-sized lateral incisor from being placed in this space. The Dolphin Imaging animation to the right illustrates this problem.

The canine teeth are not always ideal for replacing the missing lateral incisors. Therefore the spaces must be opened to allow for replacement.

 

Initial

No Implants

Implants

It is the role of the orthodontist to straighten the teeth, open the spaces and idealize the bite. After the braces are removed, implants are placed once it is confirmed that the patient is not growing, often around 18-20 years of age, and porcelain crowns fabricated by your dentist  to cover the implants. The Dolpin Imaging animation below, Anterior Tooth Implant, demonstrates this process.

 

Enlarging Lateral Incisors

 

Even when the lateral incisors are not missing, one or both can be unusually small. This presents problems both in appearance and in correcting the bite. The primary problem is with spacing between the upper teeth. This happens because the upper front teeth have to be wide enough to wrap around the lower teeth. Too narrow incisors results in spaces which can not be closed without affecting the bite. The solution is to straighten the teeth with braces, leave the necessary space around the lateral incisors, and then enlarge them once the braces have been removed. The Dolphin Imaging animation to the right demonstrates how composite bonding material can be applied to create incredibly realistic changes to the teeth. Once again, advancements in technology have allowed for restorations that are both beautiful, affordable and capable of lasting many years.

The case presented here shows lateral incisors that are relatively small in relation to the central incisors. This is also an important concept in creating a beautiful smile. Beauty and harmony in nature are dependent upon proportionality of size. Small lateral incisors, in relation to the large central incisors, not only present a problem with spacing, but are also not as pleasing to the eye. Consequently the smile is not as pleasing as it could be.

Initial

Initial 2

Initial 3

Finished

A second method of enlarging lateral incisors is with porcelain crowns and veneers. Both methods are used to create outstanting results. The case presented has porcelain veneers which provided an incredibly realistic appearance next to the natural dentition. A technique that allows for preservation of more natural tooth structure, veneers can last for many years and provide an unrivaled improvement in the beauty of the smille.

 

Anterior Tooth Implant

 

This final case presents what is possible when dental professionals collaborate to provide a patient with state-of-the-art dental care. In this case, the upper-right central incisor is discolored because there is an infection at the end of the root and significant resorption of the root.

While orthodontics was able to align the teeth, it was necessary to remove the central incisor and place an immediate implant on the day the tooth was removed.

When you click on the photos you will see that the implant site emerges from the tissue in such a way that an abutment can be added to this and a porcelain crown can be  placed over the abutment. The Dolphin Imaging animation shows the titanium implant being placed in the socket, the gold-colored abutment placed into the implant and then a crown placed over that.

 

Implant Initial 1

Implant Initial 2

Implant Initial 3

Implant Initial 4

Implant Finished 1

The final photo, when clicked, shows that both central incisors have beautifully fabricated crowns that harmonize wonderfully with the natural dentition. The results are stunning: the patient is elated with the results and able to present herself to the world with renewed confidence and the satisfaction of a gorgeous smile!

 
  
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