A makeover case involving existing and future tooth implants.

This digital smile makeover involves a situation where a person has already had some dental implants placed, and additional ones are planned. It provides an example of some of the difficulties a dentist can face when restoring implants (in this case, by way of placing dental crowns).

Case history and concerns:

This person already has two implants and is getting more. -

In the email accompanying this person's picture, he stated that the two upper teeth to the right of center (his upper right incisors) are dental crowns supported by dental implants.

He also reported that because of damage to the tooth's root, the upper tooth left of center will also have to be extracted and an implant placed.

As a side note, the color of the porcelain used to make the crowns for the upper right incisors is off just a little. It's too grey.

Why this smile looks strange. -

When you look at this person's "before" picture, notice how all four of his upper incisors are similar in size and shape (most notably, the width of all of these teeth is about the same).

That's not a typical appearance. Usually a person's central incisors are both wider and longer than the lateral incisors that lie to each side of them.

The teeth in this smile are too uniform in size.
Smile makeover where the relative size of the teeth has been corrected.

Photo submitted by website visitor.

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Treatment solutions:

1) Placing new dental crowns. -

Our "after" picture illustrates how this person's smile might be changed by way of placing new dental crowns on all four upper incisors (the two existing implants, the future implant, and the one natural tooth).

As you can see, we've shown an appearance where the teeth have been given an arrangement where the central incisors are longer and wider than the lateral incisors to their sides. This is a normal configuration for upper front teeth.

2) We'll admit, our results are easier said than done. -

We realize we've just touched up a picture, not real teeth. And there can be a number of factors that might present themselves as obstacles in getting the results we've shown.

One of the biggest is implant positioning. Have the existing implants been placed in a position that allows for the changes we've shown? Can the future implant be positioned properly? Also, does this person's bite place any restrictions on the lengths of the teeth?

These are all questions that can only be answered by the treating dentist. We will say, however, up to this point this smile has been constructed in a piecemeal fashion. Possibly if the dentist is given the opportunity to reconstruct all of the crowns at the same time they could achieve a more natural-looking appearance.

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