Replacing a damaged front tooth using a dental implant.

This smile will soon be loosing a tooth. This person's dentist has determined that their upper right central incisor is beyond repair and must be extracted.

So, we're using this digital makeover to explain issues associated with dental implant placement. In addition, we've also shown how the use of crowns and/or veneers on additional teeth could really help to improve the overall appearance of this smile.

Case issues and concerns:

a) The upper right central incisor:

This is the tooth that's been identified as having the irreparable problem.

When you look at it, you can see that its size, shape and color are all just a little bit off. To a dentist, those factors plus the redness of the surrounding gum tissue hint that this tooth has had a dental crown placed.

Any dentist would guess that this tooth has probably already had root canal treatment (hence the reason for the crown). And that some complication associated with its root (such as a crack) is its current underlying problem.

b) Other issues:

  • Also on the right side, notice how the eyetooth's positioning makes it look way too prominent.
  • Its neighbor, the lateral incisor, is positioned in a way that makes it look too short.
  • On the left side, the shape and alignment of the both the lateral incisor and eyetooth could use some improvement.
  • The dark center tooth needs to be extracted.
    The dark center tooth needs to be extracted. The dark center tooth needs to be extracted.
  • After dental implant placement.
    After dental implant placement. After dental implant placement.
 

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Treatment solutions:

Explaining our "after" picture is simple enough. It shows:

  • The type of look that could be expected if a dental implant was used to replace the tooth that's slated for extraction.
  • The combined size and shape changes that could be made for the remaining teeth by way of placing either dental crowns or veneers.

Crowns or veneers?

This person's dentist is the one who will make this determination.

Other considerations

This case does involve a couple of issues that the dentist and patient should discuss before it's started. Just so there are no surprises that come up, either during treatment or after.

a) Will root canal treatment be needed?

We've illustrated a large shape change for the upper right eyetooth. And placing a crown that results in this degree of change will probably involve a significant amount of tooth trimming. So much, in fact, that root canal treatment may be required.

b) The eyetooth on the right side still looks too large.

You may have noticed that even when scaled down as much as we've shown, the right eyetooth still looks too long compared to its match on the other side.

This problem crops up because of the position where the tooth comes out of the gums (a situation only having dental braces could change). For that reason, with this treatment plan, there's no solution for this problem.

c) Will the implant look natural?

If a dental implant can't be placed in the ideal jawbone location, it can be difficult for the dentist to get a natural tooth/gum line appearance. So, the dentist should be asked: Are there any issues here? Is there any reason not to expect the implant to look perfectly natural?

In the case where there is some uncertainty, the predictability of the appearance of a dental bridge might make it the better treatment choice.

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