Using porcelain veneers to improve the symmetry of worn teeth.

For the most part, this virtual makeover case simply involves a smile that needs improved symmetry.

The upper teeth.

For whatever reason (we assume wear, see below), the upper left and right sides of this smile have a different look. That's not, however, what we expect to see when we look at someone. Instead, we expect the situation where both sides of the mouth are mirror images of each other.

The lower teeth.

Compounding this person's cosmetic issues are their lower teeth. When we look at a smile, we expect to see a smooth, symmetrical transition from the biting edge of one tooth to another. With this case, the worn edges of the lower teeth give them a slightly irregular appearance.

The solution.

Our digital makeover shows how the placement of restorations on the upper front teeth, and just a little tooth buffing and reshaping for the lowers, could go a long way in helping to give this smile a more uniform look.

Case issues and concerns:

a) Tooth alignment.

When you look at this person's bottom teeth, you can see that they're arranged at two different levels. A lower one that involves the right and left back teeth. And a slightly higher one involving the front ones.

Related to this configuration, this person has what is termed a "deep vertical overbite." This term simply means that when this person closes together, their upper and lower front teeth overlap significantly.

b) Tooth wear.

People who have a deep overbite frequently show signs of tooth wear. With this case:

  • The curvature of the biting edges of the upper and lower teeth generally seem to mirror each other. This is typically a sign of tooth-against-tooth wear.
  • The biting edges of several of the teeth appear chipped and irregular. This is often due to the fact that as enamel wears thin it chips easily.
 
  • Tooth wear has taken away this smile's symmetry.
    Tooth wear has taken away this smile's symmetry. Tooth wear has taken away this smile's symmetry.
  • Smile symmetry restored by placing veneers.
    Smile symmetry restored by placing veneers. Smile symmetry restored by placing veneers.
 

Photo submitted by website visitor.

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Treatment solutions:

a) Orthodontic treatment should be considered.

The type of tooth alignment issues displayed by this case can only be resolved by way of having orthodontic treatment.

People who have deep overbites frequently do experience significant tooth wear. So having treatment would provide a benefit throughout the remainder of this person's life, since otherwise the same wear tendencies would continue to exist.

Of course, choosing to proceed with this approach is a decision that can only be made by the patient. For the purposes of our makeover simulation, we assumed that no orthodontic work would be performed.

b) The upper teeth.

Our "after" picture shows the type of improvements that placing porcelain restorations could make for this smile. (Either veneers or crowns, only the treating dentist can decide which makes the more appropriate choice. Here's information about some of the differences between the two.)

The idea is to use the restorations as a way of getting the right upper teeth to mirror the shape and alignment of the left ones as closely as possible, thus giving this smile its missing symmetry.

c) The lower teeth.

Just doing some minor reshaping of the lower teeth would help to give them improved left-to-right symmetry.

In most cases, this type of change can be made quickly, easily and painlessly just by buffing and trimming the teeth with the dentist's drill.

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Input from site visitors.

My lower front teeth becomes

My lower front teeth becomes too small because of the biting pressure, i wanted to have crown porcelain to improve but my dental x ray shows that my teeth are too small and there is no assurance for successful result. My teeth might weaken if crown porcelain will used. Is the porcelain veneers much better and is the venners the best solution for my problem?thank you

MTS

Generally speaking, veneers make a poor choice for people who brux their teeth (grind their teeth, "front teeth becomes too small because of the biting pressure").

It seems unlikely that a dentist that is evaluating a patient who is unhappy with the appearance of their teeth wouldn't simultaneously be considering any and all possible options (a dentist wants to satisfy patient needs, they also want to sell dentistry). So if you'll call back and ask, they'll probably be able to answer your question because they have considered it.

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