Straighten front tooth before crown, or can a crown alone fix it? (Photo)

Question

What would be the best treatment plan for this tooth with consideration for its best long term health? Post and crown? Straighten then post and crown? ... Top left tooth was broken, had a root canal, and a "temporary" covering for a couple years now. The temporary covering was made against the right tooth for support, but now there is a gap as seen in the photo from below. The tooth has always been shifting. Should I be concerned that this will continue to shift after a crown?

Ira Shapira, DDS · Answer

I would suggest you do the post and core and a permanently cemented temporary crown and then address orthodontic crowding.  You will get a far better esthetic outcome doing ceramic crown after teeth are properly aligned.  The tissue heights are very irregular due to tooth position and you would like the entire smile to be right, not just one tooth.I would also strongly0000000000000000000 suggest you investigate a DNA Appliance and Epigenetic orthopedics / orthodontics rather than braces or Invisalign.  You have a very narrow maxillary arch and a 6 tooth smile.Ideally growing your jaws will not only give you a prettier smile but also a full wide healthy smile and healthier physiology.  This will be far more resistant to orthodontic relapse........................It will result in a full healthy smile that reduces your risk of TMJ disorders, headaches, migraines, sinus issues, snoring and sleep apnea.Ira L Shapira DDSChair, American Allegience of TMD OrganizationsDiplomat, American Academy of Pain ManagementDiplomate, American Board of Dental Sleep MedicineFellow & Regent, International College of CranioMandibular OrthopedicsThinkBetterLife.com..............................................................

Gary Braunstein, DDS · Answer

In my opinion, it would be better to straighten your teeth and get that front tooth into good alignment with the other teeth prior to having a crown.  This will assure better long term stability and health.  You could have a crown done without straightening, but there are a few concerns that will affect the final appearance.  Your tooth with the root canal is presently longer than your other front tooth.  By trying to correct the position of this tooth with a crown will require significantly more tooth reduction than if it is done after straightening. Also, as the tooth is moved inward with a crown, the width of the tooth will become narrower, making the tooth length difference even more prominent.  If you decide not to do the straightening, you should consider having some cosmetic recontouring of your gum tissue on the the two teeth to your right(viewers left in photo) before you have the crown made.   This will allow those teeth to be the same length as the teeth on the opposite side.  If there is still a height discrepancy between your front teeth after straightening, then it would still be advisable to have the gingival recontouring done before you have the new crown fabricated.  If you are concerned about the appearance of your front tooth during the time that it will take to straighten, you can have some temporary bonding done to mask out the large seam where the tooth and present composite meet.  This should be a quick and affordable procedure.  Your teeth may continue to shift whether you straighten or not.  After your teeth are realigned, either with straightening and a crown, or with a crown alone, you should have a retainer made that you wear when you sleep.  This will prevent future shifiting.  Good luck, hope you find this information useful!

Elizabeth Reiser-Loeber, DMD · Answer

I agree with what others are saying.Orthodontics (braces) would be best, then crowning the tooth due to a large existing - and failing! - restoration. Prior to braces, you can redo the filling so it looks better while getting your teeth straightened. Then after braces, if your gums are still out of alignment you can get that fixed prior to doing a crown.

Sue Wendling, DMD (retired) · Answer

Your front tooth could appear straight after crown placement by a very experienced cosmetic dentist. However, the gumline discrepancy between the two front teeth is pretty dramatic. Please consider some type of orthodontics prior to crown placement.

German Arzate, DDS - Account Suspended · Answer

You have 2 optionsif you dont mind about time aprox , 1 year .braces would be a great option, you will align all the teeth and have an even smile , and at the end , you can perform the crown.and second option :if you would not set braces due to stetics , and time is also an issue, i suggest you shoild get crowns at least 6 of them or veneers on the other teeth, so that way you will have a more even smile .you will be able to change shape size and color.but yes you have a solution!

Straighten front tooth before crown, or can a crown alone fix it? (Photo)

Answers (5)

Answer: Crooked front tooth

Answer: Crooked front tooth

Answer: Strainghten front teeth

Answer: Strainghten front teeth

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Straighten front tooth before crown, or can a crown alone fix it? (Photo)

Answers (5)

Answer: Crooked front tooth

Answer: Crooked front tooth

Answer: Strainghten front teeth

Answer: Strainghten front teeth

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Recommended reading

Everything you need to know about Dental Crown

Our mission is to create a world where every investment in modern beauty is Worth It.