Gary Lederman, DMD

Invisalign, especially when combined with Acceledent, can quickly create excellent outcomes in cases like yours.  You did a very nice job with your photos!  Proper diagnosis will help determine if teeth will need to be removed.  I do think the wisdom teeth will need to be removed.  The anterior crossbite can easily be corrected with Invisalign.  Once a proper diagnosis has been made, there are many ways to move teeth to achieve the final desired result.  Invisalign is just a tool.  Don't get stuck on any one treatment type, and get several opinions!

Not sure I understand the question, or why #8 is being removed, why there is not lingual enamel, or why you would remove #24.  I assume the lower teeth are very crowded, and their position contributed to the damage on 8/9.  Acid is also a concern.  I would try to save the teeth, and maybe do some orthodontics to better position them.  If that is not possible, I would prefer to place an implant because the size of the implant will be more similar to the size of the root of #8 than the lower incisor root will be.  And implants are much more predictable than transplants.

Without knowing the details of your situation, I will give a general answer.  Overbites can sometimes be corrected with crowns or veneers.  This can be very invasive and costly.  There are orthodontic techniques that hide the brackets and wires behind the teeth.  Clear aligners (Invisalign, Clear Correct) are almost undetectable.  You can also use clear or tooth colored brackets and wires.  Often, there is some combination of prosthetics and orthodontics to get an ideal result.  You will need to consult a dentist. 

The goal is to place the implant is in a position that insures the final result is correct.  The guide (template) insures the implant will be where it needs to be.  Some doctors are excellent at precise placement of implants, but often the doctor that makes the crown has to adapt the abutment and crown to compensate for imperfect implant position.  You can never go wrong with using a guide.  Most importantly, you have to have confidence in the surgeon and trust his/her judgement.

Hi,

From your photo, it looks like you may benefit from longer teeth.  it will make them look narrower.  But you more be evaluated on how a change will function AND how it will look.

You can have a very feminine smile and still make your teeth more square.  it just requires the right cosmetic dentist with the ear for listening to your desires. an eye for detail and the patience to transform your desires into your smile.

I would suggest you make a small investment in a mockup that will give you a sense of what is possible, and see if you like the change.

Good luck!

The options available today are remarkable.  While proper planning is important, i have personally done hundreds of same day CEREC veneers with remarkable outcomes. Today, the blocks have built in color, and can be further customized with cutback of the porcelain or staining.  There need not be  an esthetic compromise with a same day approach.  It does make for a long day.

Some patients need a provisional phase.  i recommend this for very large changes.  For smaller cases, CEREC same day dentistry is a very predictable and beautiful option. 

If you want to consider same day veneers, look for a dentist with a lot of CEREC experience, who will customize the outcome to meet your needs.

in a word...CEREC! 

While I agree the ideal result is achieved as a joint effort between dentist, client and lab, most of the time I use CEREC.  it is highly precise CAD-CAM fabrication.  The porcelain is milled, not pressed. 

There are many options, just as there are in lab-based materials. 

We can offer highly customized outcomes with conventional procelains, Empress porcelains and now , VERY strong e.Max porcelain. 

The advantage is the dentist controls the outcome, and it can often be done in a single visit. 

Because the ceramic blocks are made in a factory, it is very uniform in its manufacture,  And you can't beat the way computer fabricated veneers will fit!

Cosmetic dentistry can help you. 

Space closure can be accomplished while maintaining good tooth sizes and proportions with either porcelain veneers or direct resin veneers. The trick is to include enough teeth, eight or ten in your case, so the tooth enlargement can be shared..Porcelain will last longer than resin.

You present two challenges:

First, the right and left sides are not the same.  the lack of symmetry must be addressed to have a beautiful outcome. 

the second challenge is that you describe "slight TMJ."  Bite problems lead to TMJ issues. 

without knowing what your TMJ issue is, I  would caution you to sort that out before you make any changes to your teeth. 

Finally, I would not rule out orthodontics to correct your bite and eliminate the TMJ issues.

Good luck