I'm getting Braces & my 2 central incisors need to be removed - Implant vs crown for central incisor? (photo)

Question

I'll be getting braces and unfortunetly my two central incisor are not good they have to be remove.my ortodoncy and dentist are making me confuse what is the best for perfect smile *replace the central incisors with implant and remove the canines *replace the central incisor with the lateral incisor and keep my canines The ortodoncy want to make my lateral incisor (give shape with a crown) my new central incisor and my canine be the new lateral incisor and the others teeth move with the braces

Norman Huefner, DDS · Answer

Yes, what your orthodontist is recommending is a very viable approach and I have used it many times in my cosmetic dental practice.  However, after they remove your central incisors and close the spaces you will no doubt need to have porcelain veneers to complete the job.  Lateral incisors are smaller than the central incisors they are replacing, thus would need veneers on top of them to make them larger and the same size and shape as central incisors.  Also, cuspids are more round and longer than lateral incisors, so veneers would be used to make them smaller and flatter, and the same shape as a lateral incisor.  And, to complete the job, your cosmetic dentist will also probably recommend that he make your first bicuspids look like the cuspids...again, by using porcelain veneers.My strong suggestion is to get an experienced cosmetic dentist involved to work with your orthodontist FROM THE START!  Your cosmetic dentist can help your orthodontist determine the proper placement (from an esthetic standpoint) of each of the teeth so the the veneers will do the job they are intended to do.

Lawrence Singer, DMD (in memoriam) · Answer

I would seek more opinions before getting to a treatment plan.  Certainly you need a team that is thinking on the same page.  If you must remove the central incisors I would go with the orthodontists plan and mesialize the laterals into the central position.  That should give the best esthetic results. Usually we try to avoid placing two implants next to each other in the front in an esthetic case like yours.  The best esthetic results are when you have a natural tooth on either side of the implant.  The other possibility is to put one implant in the position of one of the centrals and then cantilever the other.  You use gum grafts to build up the other site.  Hard to explain here.

Thomas Roberts, DDS (retired) · Answer

A challenging treatment plan.  First of all if there is any way to save your central incisors I would encourage you to do so.  If they are hopeless then I would consider the following treatment plan.  Shift the laterals into the central position and veneer these teeth to look like centrals.  Place implants to replace the lateral incisors.  This treatment plan avoids a significant problem.  It is very difficult to get the tissue to look right when two implants are placed side by side.  Especially in the front of your mouth.  The one caveat to this is that you don't appear to show your tissue when you smile so two implants in front may work but should be carefully considered.  Good luck to you!

I'm getting Braces & my 2 central incisors need to be removed - Implant vs crown for central incisor? (photo)

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I'm getting Braces & my 2 central incisors need to be removed - Implant vs crown for central incisor? (photo)

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