Using crowns to partially close a very wide tooth gap.
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.)
This gap is unique because of its width and the irregular alignment of the teeth that frame it.
Case issues and concerns:
Here are the most notable issues we noticed with this smile.
This person has a diastema between their two central incisors. It is quite wide.
The irregular angulation of these centrals amplifies the presence of the diastema.
The upper lateral incisors are very short which, once again, makes the diastema stand out.
“Before” photo submitted by website visitor.
1) Partially closing in the gap by placing crowns. –
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.
Why only partially fill in the space?
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.