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Need Braces and Two Upper Central Incisors Implants, How to Go About It?

23F as a child sucked my thumb and pushed out the upper teeth to the front and the bottom ones slightly to the back. In first grade when i finally decided to get braces i broke my second upper central incisors and had to get crowns. I've been told that i'll need to get those teeth redone after 10 years because they'll be too small in comparison to other teeth but i never did and now my dead teeth underneeth are gray. I still need the braces as well and have no idea how to go about it all. Help!

Doctor Answers (4)

Implants and orthodontics can be an effective combination

+1

It is difficult to give you an accurate plan without seeing you, but we do these types of cases all the time.  The ultimate space for the implants needs to be balanced with the overall occlusion (bite). From your description it is possible that you would need some expansion of the dental arches to make the implant sites wide enough to create the best aesthetic result.  After a plan is agreed upon, the orthodontist can communicate with your family dentist and the dentist doing the implants before completing treatment and removal of braces to make sure adequate space is present for the implants and later crowns.  Just look for someone who has significant experience as there are a number of ways to get a poor result.  I hope this is helpful.  Good luck.


Denver Orthodontist

Upper incisor esthetics

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It sounds like your case is somewhat complex.  It is difficult to determine if the two front teeth are going to lost, or if they can be salvaged.  In a case like yours the services of an experienced cosmetic dentist and periodontist, assisted by an orthodontist, may provide the best care.  If the two front teeth are going to be replaced by implants it's important to have the implants done by an individual who is very aware of the nuances of how to create lifelike implants/restorations.  There are many individual dentists who can do all of the necessary procedures, but in a critical esthetic case specialized care may give a bettter end result.

Brian Povolny, DDS, PhD
Seattle Orthodontist
5.0 out of 5 stars 2 reviews

Braces and damaged teeth

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I would consult with your dentist and tell the dentist that you are having orthodontics.  I would have the orthodontic treatment before you place new crowds or bonding on the front teeth.  The orthodontist will space out the teeth in such a way that there will be space for new full size crowns.

If the teeth are gray, this may indicate that you might need root canal treatment on you front teeth.  This should be done before orthodontic treatment, and permanent crowns done after treatment.  Your dentist should coordinate with the orthodontist and endodontist if one is being used.

Thomas Braun, DMD
Fairfield Orthodontist

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Braces, Implants, Etc.

+1

It sounds like you have a "multidisciplinary" case.  Meaning you potentially need several different dentists to treat your case.  You will need a dentist or orthodontist for the braces, a dentist or oral surgeon or periodontist to do implants (if needed), potentially a dentist or endodontist for your "dead teeth," and a dentist or prosthodontist for any crown work you need.  It is always advantageous to find all of these dentists in the same office if possible but that can often be next-to-impossible to do.  I wanted to be able to treat your kind of case all in the same place so my patients don't have to travel all over town seeing different dentists.  However, you will need to go to a general dentist first and foremost because he or she will act like the general contractor.  SOMEONE has to be in charge of the whole project.  If you go to the orthodontist and he moves teeth into a position that makes implants impossible then who is going to take responsibility?  If you have implants placed in a position that makes restoring them impossible or a cosmetic compromise, who is responsible?  The general dentist needs to act like the general of your treatment and take responsibility for the entire project.  Therefore you need a general dentist who is familiar with complex treatment plans like yours and has access to specialists who are competent in working on multidisciplinary cases.
Take your time; get multiple consults if you don't feel 100% comfortable with what is being recommended.  Have fun and good luck!

Brad Lockhart, DDS
Tustin Cosmetic Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.