So to review….this patient has a fractured front tooth that will need a crown. But he’s not ready for that yet, and still wants to have a better looking smile.
A few minutes later, the tooth is once again presentable and will function well for the near future.
So this gentleman is not ready to crown his teeth, but there is a large fracture. It doesn’t hurt, but esthetically it looks less than ideal. He’d like a temporary ‘fix’ until we can crown it (which, again, he is not ready to do right now). What to do???
This young man has recently finished braces, and the orthodontist sent him to us because of the gap that was left between these two teeth. All the other teeth were placed ideally, and if this space was closed the other teeth would be in the wrong spot so they would not function correctly or look right. So we talked about bonding to solve the problem.
As you can tell, I obviously did not think these teeth were in need of veneers. A little bonding and a few minutes later they looked like new! I told the patient that she might EVENTUALLY need more definitive restorations (veneers) but for now the bonding was the easiest, least invasive, least expensive alternative. She was thrilled with the results!
Here’s a patient that was told she’d need veneers due to the ’severe’ chipping and breakage of her front teeth. Now of course she didn’t like how the teeth looked, but she wondered if she really need something as costly and invasive as a veneer. Take a look below….what do you think??
Chipped, broken teeth-before bonding
And so to review…..we started with two very small lateral incisors.
Small laterals before ortho and bonding
Ultimately we decided to go with the first discussed option…..leaving ideal spaces and then bonding them closed. Now I have to warn you—-the orthodontist has to be VERY good for this work. If not, you will end with two teeth that do not match in size or proportion. Here’s the first tooth, before and after:
Small tooth with spaces before bonding
Tooth after bonding to close spaces and correct the size
We (the orthodontist and myself) discussed our two options.
1. Move the lateral incisors into the middle of the spaces, bond the teeth to make them ideal for size and proportion, finish the orthodontics.
2. Complete the ortho, leaving ideal spacing for the laterals, THEN bond the teeth after the orthodontics is finished.
Both are fairly difficult. We’ll talk about them in separate posts.
Your discussion should revolve around the ultimate goal for these teeth. If the size discrepancy is small, then everyone may agree to simply close the spaces during the orthodontic treatment. However, many times the size difference is too great to do this:
I won’t show the tooth completely cleaned out, but it turned out to have a very deep cavity. However, after placing the filling, you can barely tell the tooth had any work at all. It came out great!
Finished filling
