Using orthodontic treatment to bring an impacted front tooth into place.

Some smiles appear to have a "missing" tooth when instead the tooth is actually impacted (still lies buried in the jawbone). This digital smile makeover illustrates how orthodontic treatment might be used to remedy this type of situation. (A second approach for treating this same case is explained here.)

Case history and concerns:

Why this smile doesn't look right. -

It might take a second look at this case's "before" picture to figure out why this smile looks strange. On closer inspection however, you'll discover that this person is missing one of their upper front teeth.

The tooth that is missing should lie between the teeth marked numbers 1 and 2, and should be similar in size and shape to the tooth labeled number 3.

For the most part, a person's smile is defined by their six upper front teeth. And since each of them has a characteristic size and shape, when one is missing a smile simply won't have a normal look.

Where is the missing tooth? -

The "missing" tooth probably isn't totally absent. A dental x-ray would likely reveal that it lies buried in the jawbone (is impacted) and is positioned in the region of the roots of the teeth marked numbers 1 and 2. For this makeover, we're assuming that this is the case.

  • One of this person's upper front teeth is missing.
    One of this person's upper front teeth is missing. One of this person's upper front teeth is missing.
  • Orthodontic treatment has been used to bring the impacted tooth into place.
    Orthodontic treatment has been used to bring the impacted tooth into place. Orthodontic treatment has been used to bring the impacted tooth into place.
 

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Treatment solutions:

1) Using braces to bring the "missing" tooth into place. -

The only way to make this smile look completely normal is to provide it with a complete set of front teeth. This could be done via the use of orthodontic treatment (braces). This treatment would first make space for and then guide the impacted tooth down into position.

Disadvantages -

This approach would require a relatively lengthy treatment period (probably two years or so). And a minor surgical procedure would be required to initially access the impacted tooth.

Advantages -

Overall, having braces would provide some significant benefits. With the impacted tooth brought into place, the smile could be given an essentially perfect appearance. And, although too complex to illustrate it in our "after" picture, the alignment of all of the teeth, both top and bottom, could be perfected too.

2) Completing the case. -

This case's "before" picture shows that the biting edges of this person's upper center teeth have worn. Once their malocclusion has been corrected, the shape of these teeth could be idealized by placing porcelain veneers. As an alternative, the treating dentist might be able to simply buff and trim their edges to a point where they look acceptable.

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