Replacing missing lateral incisors with tooth implants.

This digital smile makeover involves a case where the person is missing two upper teeth, their lateral incisors.

As a short-term fix, their dentist has bonded two artificial teeth in their place. (The fake teeth are the two smallest uppers you see.)

Although their size and angle doesn't look exactly right, using this approach as a temporary solution certainly makes a reasonable choice. Especially considering the alternatives where just spaces or very tiny baby teeth would exist, or the patient would have to wear some type of removable appliance.

Beyond just the missing-teeth issue, this person sent additional pictures and explained some of the other objections they had with their smile.

Case issues and concerns:

These are the major concerns this person has:

  • The replacement of the missing upper lateral incisors. (And doing so in a fashion where they don't look too narrow and angled.)
  • Giving the upper eyeteeth a less pointed look.
  • Creating a more even alignment for the biting edges of the lower front teeth.
 
  • With the temporary replacements for the lateral incisors in place.
    With the temporary replacements for the lateral incisors in place. With the temporary replacements for the lateral incisors in place.
  • After orthodontic treatment and implants placement.
    After orthodontic treatment and implants placement. After orthodontic treatment and implants placement.
 

Photo submitted by website visitor.

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Treatment solutions:

The problem with just using restorations (crowns, veneers, implants) to make cosmetic changes for a smile is that the original underlying difficulties still exist. The dentist just tries to work around and hide them.

With this case, it seemed that using that approach would simply result in an outcome that would be similar to what already exists.

A better plan.

The more ideal treatment approach would be to use orthodontic treatment to both idealize the alignment of the teeth and the width of the existing spaces.

Then afterward, normal-sized artificial teeth and other needed restorations could be placed. Overall, this outcome would give the more normal-looking appearance.

What's needed.

In regard to using this treatment plan, here's what we've illustrated in our after picture.

The upper central incisors.

These teeth don't really require all that much attention.

When comparing the before and after images, it's easy to see how just trimming the biting edge of the right one a little creates two teeth that are essentially mirror images of each other.

The upper lateral incisors.

Our makeover illustrates how after orthodontic treatment has been used to widen the spaces where the lateral incisors go, full-sized replacement teeth (dental implants with crowns) could be placed.

The upper canines.

A comparison of this case's before and after pictures hints that during this person's dental growth and development their eyeteeth had opportunity to shift too far forward.

That's why the space that exists for each lateral is now too narrow. It also explains why the eyeteeth seem flared out.

Our after picture gives an idea of how orthodontic treatment might be used to give them a more angled-forward positioning.

Another issue with these teeth is that they are very pointed.

Possibly just trimming and/or adding dental bonding to them could give them the appearance that we've shown in our after picture. If not, porcelain veneer placement could be used to make this change.

The lower teeth.

Our after picture illustrates how having orthodontic treatment could even out the level of all of the lower teeth.

And trimming the biting edges of the front ones (after/during this treatment) would help to line up their biting edges.

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