Digital smile makeovers
This page's digital makeovers illustrate how "tooth gaps" can be filled in by placing dental crowns. (Dentists refer to this type of space as a diastema.) Each case also explains some of the difficulties dentists encounter when doing so, and alternative treatment approaches.
Case #1: Fully closing in the space between two incisors by placing crowns.
Dental history and concerns:
1) When you first look at this smile, your eyes are immediately drawn to the irregular biting edges of the teeth and, of course, the relatively large tooth gap. (Dentists refer to this type of space as a "diastema.")
2) Other than that, these teeth look pretty nice. Their color is reasonable, the gum tissue appears healthy. There is some minor crowding of the lower teeth but, as you will read below, that appearance can be improved upon fairly easily.
1) Crowns for the upper teeth. - Placing dental crowns would be one way of closing this person's diastema and straightening out the biting edges of their upper teeth.
In regard to closing in the tooth gap, the idea is that the dental crowns for the two teeth framing this space are made wider, so when they are placed the gap is filled in. At times, this type of approach can result in teeth that look oversized but, as our "after" picture shows, with this case the results seem reasonable.
In our "after" picture you can see just a little bit of space remaining right at the gum line. It could be filled in too but doing so would make it harder to remove dental plaque from between these teeth. The dentist and patient would have to decide if that tradeoff is worth the risk.
2) An alternative approach. - It could be possible to get the same end result by placing porcelain veneers or else tooth bonding. For the most part, this choice would be based what type of restoration strength is needed.
If the notching of the biting edges of the teeth has been caused by tooth wear (which we assume it has), then dental crowns would make the best choice. Crowns are the strongest and most lasting type of dental restoration. The possible alternatives would be comparatively more prone to breakage and wear.
3) Improving the look of the other teeth. - Our "after" picture simulates how the minor irregularities of the biting edges of the remaining teeth could be corrected by placing white fillings (dental bonding). Additionally, if the patient felt that the minor spacing between the lower teeth was offensive, it could be closed in by placing bonding too.
Case #2: Using crowns to partially close in a very wide tooth gap.
Dental history and concerns:
1) When you look at this person's smile, the very first thing you notice is the very large space between their upper front teeth. Dentists refer to this type of gap as a diastema and this one is unique because it is both very wide and the two teeth framing it are crooked (angled off to the sides). Another factor that detracts from this smile is the shortness of the upper lateral incisors.
1) Partially closing in the gap by placing crowns. - Similar as with the simulation above, this person's diastema could be closed in by placing dental crowns. The difficulty with this case, however, is the width of the gap and how much it can, or should be, filled in.
As previously discussed, dentists close gaps between teeth by placing restorations on them that make the teeth wider. The problem is, sometimes the width of the restorations that are needed make the teeth look oversized.
That's the potential problem with this case. Will crowns that are wide enough to fully close the center space be too wide to give a natural appearance?
This is simply a question for the dentist and patient to answer. Tooth gaps are a cosmetic problem, not a dental-health one, so leaving a little bit of a space is an option.
2) Why crowns are needed. - We've specified the placement of crowns with this case, as opposed to porcelain veneers. Here's why.
When veneers are placed, only a limited amount of tooth structure can be trimmed away. With crowns, this limitation isn't as restrictive. If the apparent alignment of the two center teeth is going to be improved, a fair amount of tooth structure will need to be trimmed off. That means that dental crowns will be needed. (For more information:
What is the difference between porcelain veneers and dental crowns? )
3) Crowns for the lateral incisors. - Our "after" picture illustrates how dental crowns could be used to change the length and shape of the two upper lateral incisors.
[We should say that making these two teeth just a little bit longer than we have illustrated would probably give a more pleasing cosmetic result. But we have chosen to leave them just a little short, implying that their length may be limited by factors dictated by this person's bite. (Which with this case doesn't seem to be perfectly ideal and a reason why the alternative approach discussed next should be considered).]
4) Another treatment option for this case. - As an alternative approach, orthodontic treatment could be used to treat this case. With the single exception of the upper left lateral incisor (which shows some wear and does need some type of restoration placed), the overall shape and color of these teeth seems very reasonable. If this person would consider having braces, once their teeth were realigned, they would have an essentially perfect smile, without the need for a mouth full of dental restorations.
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