Digital smile makeovers

- Examples of how crowns can be used to rebuild front teeth that have worn excessively.

These two digital makeovers illustrate how dental crowns might be used to rebuild and restore the appearance of worn front teeth. We've stipulated the placement of crowns with these cases because they seem to be instances where the strength and durability that they offer would be required.

Case #1: Making a big improvement for a smile by placing dental crowns.

Dental history and concerns:

1) In this "before" picture, you can see how this person's front teeth, especially his center two, have worn excessively.

We'd suspect that this is an indication that this person has a deep overbite (meaning that his teeth overlap quite a bit). This, combined with a tooth-grinding habit (dentists call this activity "bruxism"), could easily result in the appearance we see in this picture.

If we had another photo taken from a different angle, we would probably see that the lower center teeth (the ones directly under the worn upper teeth) have a beveled biting edge. The idea is that as the lower teeth wear away the uppers (from their backside), the front sides of the lower teeth tend to become more and more beveled.

2) Some of the upper front teeth have white fillings that have deteriorated and stained.

3) In back, on the upper right, there appears to be some missing teeth.

Treatment solutions:

1) Rebuilding the worn front teeth using crowns. - Our "after" picture shows how dental crowns might be used to restore the shape and color of the worn upper front teeth, and the misshapen tooth on the lower left. They would be a better choice than dental veneers due to the superior strength characteristics they offer.

2) Repairs for the other teeth. - A dental bridge or dental implants might be used to replace the missing teeth on the upper right. For the lower teeth, the treating dentist could even out their biting edges (as shown in our "after" picture) by buffing them down with a dental drill.

Case #2: Repairing, and realigning, worn teeth by placing dental crowns.

Dental history and concerns:

1) This person's front teeth show a great deal of wear. Most likely it's the result of tooth clenching or grinding.

2) The alignment of the upper front teeth isn't perfect. The center two teeth are crooked. The two teeth that lie to each side seem to be set back just slightly.

Treatment solutions:

1) Rebuilding the front teeth using crowns. - Our "after" picture illustrates how dental crowns might be used to both repair the worn edges of the upper front teeth and improve their apparent alignment.

2) Why crowns make the best choice for this makeover. - One treatment alternative for this case might be to place porcelain veneers. This approach, however, probably wouldn't provide as lasting a repair. Porcelain veneers can give an excellent cosmetic result but when they are exposed to excessive forces (like those that have worn down these teeth) they can chip or break.

Since this person most likely bruxes (clenches and grinds his teeth), crowns would make the better choice. They can give the same cosmetic result as veneers but they have the advantage that they are much stronger and therefore less prone to breaking.

3) Improving the apparent alignment of the upper teeth. - The dental crowns fabricated for the teeth that seem set back could be made in a fashion where their front surface is slightly over contoured. If so, they would create the illusion of a more perfect tooth alignment (as we've tried to illustrate in our "after" picture).

A determination concerning the appropriateness of this technique, both in regards to the case's cosmetic results and its affect on the health outlook for the teeth and the gum tissue that surrounds them, would have to be made by the dentist performing the treatment.

4) Changes for the bottom teeth. - The minor changes we've illustrated for the biting edges of the lower teeth could likely be made by just buffing them down slightly with a dental drill.


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