Cosmetic smile makeover simulations: Closing (reducing) a large gap between two teeth.

Not all tooth gaps (diastemas) should be closed fully.

Case history:

This case involves handling an excess of space between some of this person's upper teeth and, at the same time, managing tooth crowding on the lower arch. There wouldn't be any question that ideal treatment for this person would involve the use of orthodontic treatment (either conventional fixed braces or possibly removable orthodontic aligners such as Invisalign). Then, after the positioning of the teeth has been idealized, those teeth still requiring shape changes could have dental crowns or porcelain veneers made for them.

Here with our Cosmetic Dentistry section of Dental-Picture-Show.com we typically don't simulate treatment plans that involve the use of orthodontic treatment. Instead we try to focus on changes that any general dentist employing basic cosmetic dentistry techniques should be able to achieve and in a relatively short time frame. Because of this, the makeover changes we have simulated for this case just involve the placement of dental crowns or porcelain veneers (the precise type of dental restoration chosen for each tooth being decided on by the treating dentist). Along these lines, here is the solution for this case that we have simulated.

About our approach to this cosmetic dentistry makeover simulation.

Placement of dental crowns on the center six upper front teeth.: When a dentist places a dental crown they have an opportunity to make significant changes with the portion of the tooth that lies above the gum line. What they have no control over is the positioning of the tooth's root. In cases such as this one where a large space (a diastema) exists, the positioning of the roots of the center two teeth constrain the dentist's ability to close the gap. If the gap were to be closed all of the way, the dental crowns placed would, at minimum, have to be grossly oversized (in width) and would result in a space between the crowns and the gum line that would be very difficult to keep clean and healthy. As a compromise, we have simulated placing dental crowns that are oversized, yet not so much so to create these two problems. (The treating dentist would have to determine the exact extent to which the width of the gap could be closed.)
Placement of a dental crown on one lower central incisor and reshaping the other lower front teeth so their apparent alignment appears more uniform.: We were surprised how simulating the placement of just one lower dental crown and then the use of a dental drill to straighten out the irregular edges of the neighboring teeth significantly improved the appearance of the lower teeth as a whole.

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