Once in a while, I see patients in my practice that have been treated by a dentist and present with crowns that have been poorly designed, and shaped in a way that does not have the right contours, dimensions, or proportions, and when these are in the smile zone they can make a person’s smile very unattractive.
Usually there is a reason why the restorations were made that way, for example, a person with spaces between the front teeth may feel uncomfortable smiling, and request crowns or bonding to close the spaces. Here is where your dentist’s training and artistic ability come in. Your dentist can analyze the size of your teeth and compare them to “golden proportions” that are well documented to be very esthetic and determine if the person can close the spaces by making the teeth bigger or if the teeth are big enough and the space closure needs to be done with orthodontics. Attempting to close the spaces by making the teeth bigger when they are big enough already can be a disaster and create a result that is not pleasing to the eye.
Another reason that dental work in the cosmetic zone can look bad is when the dentist fails to take symmetry into consideration. For example, a case where the teeth on one side are made to look larger than the teeth on the other side. This is very noticeable if the teeth in question are the two upper front teeth. They should be identical to each other, and if one is longer or wider, it is very noticeable.
Sometimes the person has had some teeth extracted, and there is a natural tendency for the teeth to shift to close the space. When this happens in the smile zone the teeth show canting, or an unaesthetic inclination, and any cosmetic work needs to correct the canting for the work to look good.
These and many other problems can be avoided by good planning on the part of the dentist. If the dentist is changing the shape or the length of the front teeth, or correcting cosmetic problems it is important to use the concept of prototype temporaries. By creating the temporaries to incorporate all the features of the desired final restoration, the dentist (and the patient) can see how the final restorations will look, and if there are any issues or problems, they can be corrected in the prototype temporaries until an acceptable result is achieved.
Utilizing prototype temporaries takes more planning, and work on the part of the dentist, but it is a necessary step when solving problems in the cosmetic zone.
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