Here’s a different view of the same tooth. Notice the ‘wavy’ appearance of the remaining tooth structure. And the slightly darker appearance the middle of the tooth has versus the outside (this can be seen even better on the other central incisor that isn’t fractured). These are important characteristics to mimic if we hope to repair the tooth and make it look realistic. If not, the added portion will be VERY obvious.
Here’s the same side tooth (the lateral) after it had some bonding added to it.
Notice the additional width, and how the small gap that was left at the tip or edge of this tooth has been closed.
Here’s a side view, after the final orthodontic movement:
To finish things off we thought we’d increase the width of the lateral incisors, too (they’re right next to the middle teeth).
After she completed the final phase with the orthodontist, she returned to me like this:
The orthodontist closed the gap, and these teeth are now in the correct position! But let’s look closer at the teeth on either side of these. What about their size?
How then do we manage the area where Cleo’s tooth is coming out? If we leave the site alone the final result will probably look less than ideal, and could potentially be disasterous. To solve this we made a temporary bridge that was shaped anatomically correct, and placed slightly under the gum line. It therefore appeared to emerge from the gum tissue where the tooth used to be. The temporary restoration was used to actually shape this gum tissue as it healed. After a number of weeks we were able to continue with the bridge process.
Let’s look at another case. Suzanne was referred to me by a gum specialist. She had braces successfully, but the space between her two front teeth continued to open. The gum specialist removed a small amount of fibrous tissue from between these teeth and asked me to look at the size of her teeth before she returned to the orthodontist. Here’s the way she looked at our first visit:
What makes this process even easier is the development of a new way to move teeth. In the past the orthodontist would have to place brackets and wires to change the alignment of teeth. This is the ‘common’ version of orthodontics. But now he has a new, high tech tool that often can be used. It’s called Invisalign. I won’t go into the details, but I will tell you that it’s by far easier and FASTER than conventional braces. And without all the added ‘hardware’ that comes with traditional braces, there’s less trauma and complications for the patient. I can’t tell you how may times I’ve had people tell me what a breeze their Invisalign treatment has been!
So if you need to have teeth realigned in order to make your dental work ideal, you’ve got a great new way to do it! Ask us about Invisalign and we can get you some more information.
So to continue with the last post. Yes, I know I’m a Charlotte dentist, and not orthodontist. But I still find the current state of moving teeth (orthodontics) to be as much an art as science. As I discussed before, straight teeth are not the only ultimate goal. 
The final ‘profile’ of the patient is just as important. Extracting a bunch of teeth to expedite treatment ultimately only helps one person….the orthodontist. When does someone need to have teeth pulled? It sure varies on a case-by-case basis, but one thing is absolutely true…..it happens WAY too often! Here’s a ‘normal’ profile after orthodontic treatment (with NO extractions!):
Had a great discussion with a local specialist about the referral pattern of some orthodontists. It seems their common treatment plan is to automatically extract 4 bicuspids, place brackets, and then pull everything ‘back’. In the end, yes, the teeth are straight. But at what expense? Take a look at the profiles of some of these cases after treatment. Instead of being full, pleasing, naturally contoured profiles it looks like their whole lower face is ‘pulled back’.
This is disturbing enough, but often these same othodontists are too quick to refer to the oral surgeon for jaw surgery to move the upper, lower, or often both jaws into alignment. Does this occur too often? I’m certainly not an orthodontist but in my opinion….yes. We’ll talk more about it later. Watch for more before and after smiles here: before and after
Saw an interesting case a few days ago. Lady had been told by a local ‘cosmetic’ dentist she needs a slew of veneers and was looking for a second opinion. She didn’t like the spacing or positioning of her teeth and was concerned with the difference in the level of the gum tissue around her front teeth. After examining and photographing her teeth I determined there was NO reason to have veneers. The teeth were perfectly healthy with no fillings or excessive wear. They were the correct ’size’ and proportion. A few months with Invisalign braces, a trip to the gum specialist for a slight alteration in her tissue heights, and some whitening (or bleaching) is all she needed. She’s heading to see the orthodontist to get started!
How many times would she have been told she needs veneers, when some ‘minor’ tooth movement is all that is necessary?
Check out a brief description of veneers here: Veneers
