Correcting an anterior crossbite using veneers and orthodontic treatment.

When this person submitted their picture for a digital makeover, they stated that they had already consulted with their dentist and were considering having orthodontic treatment and then porcelain veneers placed.

Their hesitation was, before going ahead with treatment they were hoping to be able to see what type of results they would end up with.

There's only so much our digital makeovers can illustrate.

Especially in regard to full-mouth orthodontic work, it's essentially impossible for us to mimic a patient's precise outcome. But it is simple enough to create an "after" image that reflects the general types of changes that are usually made. So, that's what we've done with this case.

Case issues and concerns:

  • We'd assume that this person's biggest cosmetic dilemma involves their upper front teeth. The way they tuck behind the lowers when they close. In dental terminology, this is called having a crossbite.
  • In similar fashion, the lower right eyetooth is in crossbite too. (It should tuck behind the upper teeth, instead it's in front.)
  • There's actually another cosmetic issue here that wasn't so readily apparent to us until we started to edit this case.

    If you'll look, you'll notice that the upper 4 center teeth are all fairly similar in size. With most people, their central incisors (their center 2 teeth) are substantially larger than their lateral incisors (the next teeth off to each side).

    Here, the size difference isn't so pronounced. And to some degree, it keeps this smile from looking quite the way you would expect it to.

    [We have another makeover that deals with this same issue. Use this link to view that case.]

  • These center teeth are relatively small and in crossbite.
    These center teeth are relatively small and in crossbite. These center teeth are relatively small and in crossbite.
  • After orthodontic treatment and veneer placement.
    After orthodontic treatment and veneer placement. After orthodontic treatment and veneer placement.
 

Photo submitted by website visitor.

[How to view other cases.]

Treatment solutions:

Correcting the alignment issues.

When this person mentioned that a part of what they had discussed with their dentist was having orthodontic treatment, we just assumed that they meant full-mouth braces. [Actually, there are several different orthodontic techniques that can be use to provide "full treatment."]

Since there are alignment issues with both the upper and lower teeth, braces could be used to resolve those points and basically idealize everything about this person's occlusion in general. (This is what we've tried to illustrate in the "after" picture.)

As an alternative, this person's dentist might determine that just realigning some of the front teeth is possible and sufficient. (It's the crossbite issue associated with several of them that's the main barrier to making the desired cosmetic changes.)

The full-mouth approach would typically be considered the "ideal" or "text-book" method. But in light of practical considerations, partial treatment might offer some appealing benefits (shorter treatment time, lower cost).

Placing veneers.

Our "after" picture illustrates how porcelain veneer placement might be used to improve the overall appearance of the upper front teeth.

As suggested above, if they are made in a fashion that tends to emphasize the width of the central incisors and diminish the width of the laterals (like we've shown), it would help to give this smile a more customary look.

Of course, this is just our take. As a criticism of our "after" picture, the added width and length we've shown for the center teeth does make a fairly large difference in the way this smile looks. And if this is more of a change than this person wants, it would be easy enough for the treating dentist to tone these dimensions down so they are more in line with what existed before.

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