"Straightening" teeth with dental crowns.

Dental crowns can be used to "straighten" a patient's teeth. When this technique is used, however, no real tooth realignment takes place (like it does with braces). Instead, the crowns simply give the teeth a different shape and angulation, so to create the illusion of having been straightened.

With all other considerations equal, most dentists would probably consider orthodontic realignment of a patient's teeth the preferred method. But in those cases where the patient won't consider this type of treatment plan, the placement of restorations (dental crowns, porcelain veneers or tooth bonding) may be the only alternative available.

Case issues and concerns:

This person's chief complaint is simply the misalignment of her teeth.

  • The two lower center teeth (the central incisors) are crooked.
  • Up on top, the teeth on either side of the center teeth (the lateral incisors and eyeteeth) are misaligned too. Their biting edges should be lower and more in line with the biting edges of the central incisors.

We will point out that since the misalignment of this person's teeth is bilaterally symmetrical (the same on both sides), the look of her smile is more pleasing, and its irregularity less noticeable, than if either side was misarranged on its own.

  • A smile with imperfect tooth alignment.
    A smile with imperfect tooth alignment. A smile with imperfect tooth alignment.
  • How crowns can be used to "straighten" teeth.
    How crowns can be used to "straighten" teeth. How crowns can be used to "straighten" teeth.
 

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Treatment solutions:

1) Improving the apparent alignment of the teeth with crowns. -

The results we show in our "after" picture could be achieved by placing dental crowns on the upper lateral incisors and eyeteeth and also the lower central incisors. (It might even be possible to make these same changes using dental veneers.) The minor changes we've illustrated for the upper center teeth could be made by placing dental bonding.

a) Reasons to choose crowns over veneers. -

Crowns would probably make the more appropriate choice for this case due to the fact that we've illustrated some major shape changes for this person's teeth (especially their upper eyeteeth). This amount of change isn't always possible with veneers. (For more information: What is the difference between porcelain veneers and dental crowns?)

b) Other considerations.

We must also state that the length of the teeth (and hence the alignment of their biting edges) would be dictated by this person's bite. It may be that the final length of the teeth can't be as long as we've illustrated. Only the dentist performing the work can make this determination.

2) An alternative approach - Braces. -

Another way to treat this case would be with orthodontic treatment (braces). We'd expect that almost any dentist would consider this to be the more 'ideal' treatment plan.

a) Having braces takes longer but has long-term advantages. -

In regard to having treatment, for most people probably the biggest difference between a crowns vs. braces approach is the amount of time that's needed. Braces will likely take 1 to 2 years, whereas the "instant gratification" method of placing crowns can be completed in just a few weeks.

A patient needs to understand, however, that over the long term there are important differences between these two approaches. With braces, maintaining the results will likely just involve the sporadic use of a retainer. In comparison, you can expect that dental crowns will need to be replaced at least once (even more, considering this person's apparent young age).

Additionally, placing crowns involves trimming away healthy tooth structure and makes maintaining healthy gums more of a challenge. These are very important considerations and topics that should be discussed at length with the treating dentist before any treatment plan is accepted.

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