Hiding the fact that lateral incisors are missing by placing porcelain veneers.
This digital smile makeover involves a case where the person is missing their upper lateral incisors. These are the small teeth that should reside between this person’s central incisors and their eyeteeth.
It’s not terribly uncommon for a person to be “missing” them. What is of note here is that this person stated they are truly missing, as opposed to being impacted (misaligned and still buried in the jawbone).
Veneers vs. orthodontic treatment?
When this person submitted their makeover request, they titled their email “veneer simulator,” so obviously the idea of porcelain veneers was on their mind.
When we first looked at this case, we initially thought it should be an orthodontic one. One where the teeth are realigned so enough space is made so artificial lateral incisors can be placed.
Since that didn’t seem to the the solution this person was looking for, we illustrated it as if only veneers (possibly even no-drilling veneers) were placed and no other treatment. In the end, we were pleasantly surprised at how relatively normal and natural the “after” picture looked. We explain why below.
Case issues and concerns:
As mentioned above, this person is missing their upper lateral incisors.
There’s a gap (a diastema) between the upper central incisors.
The edges of both centrals are chipped or worn.
“Before” photo submitted by website visitor.
For the most part, a person’s smile is made up of their center 6 teeth, the central incisors, lateral incisors and eyeteeth.
Each of these kinds of teeth has a characteristic relative size and shape, and when one of them is missing it tends to stand out. The smile doesn’t look right.
That’s why we initially thought that treating this case just by placing veneers might not give a good outcome.
With this makeover there are two basic obstacles.
A) The central incisors.
There’s a space between these two center teeth. And when veneers are used to close a gap like this, the only way to do it is by making both teeth wider. The concern then becomes, will they end up looking too wide?
Once we saw the outcome in our “after” picture, it seems to us that, yes, these teeth teeth are large but not unreasonably so.
B) The eyeteeth.
Eyeteeth have a pointed biting edge whereas lateral incisors are straight across.
When laterals are missing, one plan of action can be to try to make the eyeteeth look more like lateral incisors. Doing so gives an appearance more along the line of what’s expected. (This plan is what we’ve illustrated in our “after” picture.)
The problem is, sometimes when this is done the smile just looks too straight and even across. It may look better than before but still not natural.
With this smile, to us, it seems that that’s not the case. Once again, yes, the teeth are larger but the uniformity and symmetry that’s been created gives nice end result. At “conversational distance,” were not sure anyone would realize that there are missing teeth.