Recontouring of Incisal Edges

10.1055/b-0034-75546

Recontouring of Incisal Edges

Recontouring of teeth includes additive as well as sub-tractive measures. Reshaping of teeth mostly benefits the visible aspect of the anterior teeth and is therefore regarded as a cosmetic procedure. Enamel reshaping of ragged or chipped incisal edges of the anterior front teeth, particularly on the incisors and canines ( Fig. 8.23 ), is the most commonly used procedure.

Additive procedures such as composite veneers or incisal edge build-ups can be used to treat enamel defects (see Case Study 8.5) or conical tooth shapes; it is also useful in adults, in whom widening of teeth can reduce or eliminate triangular-shaped spaces at the gingival level or restore microdontic teeth to better proportions ( Fig. 8.24 ). Additive measures can also be useful for restoring tooth shape in substitution cases (e.g., canine for lateral incisor).

Fig. 8.23a–d Correction of incisal wear at the maxillary incisors. Persistent malocclusion can lead to unphysiological, asymmetric wear patterns on teeth that become particularly evident after the teeth have been properly positioned (a). Correction of minor defects can usually be achieved subtractively, by polishing with a diamond disk (b–d). The larger surface area of the flat disk prevents the instrument from becoming caught in the notch and accentuating the irregularity, as may happen when a conventional bur is used.
Fig. 8.24a–c The final result of orthodontic treatment. The microdontic tooth 22 was built up directly with composite (a, b). The edentulous site 12 was restored with a fiber-reinforced adhesive bridge (Everstick, Stick Tech) (c).

Case Study 8.5 (Fig. 8.25)

Patient: S.K., female, age 13.

Diagnostic records: models, panoramic radiograph, lateral cephalometric radiograph, intraoral/extraoral photographs.

Main findings: amelogenesis imperfecta, early loss of severely decayed first molars, lack of arch coordination.

Treatment aims: interdisciplinary goal: to establish a stable occlusion and archwire coordination; restoration of malformed enamel surfaces.

Appliances: self-ligating brackets, molar bands.

Archwire sequence: 0.012 SE, 0.016 SE, 0.016 × 0.022 SE, 0.019 × 0.025 SE.

Alternative treatment strategy: n/a.

Active treatment time: 5 months.

Retention: three-dimensional retention.

Fig. 8.25 1–12 1–3 Self-ligating brackets in place and an initial SE wire for leveling, alignment, and arch development. 4–6 Self-ligating brackets allow rapid and gentle alignment of teeth. This can be particularly useful for patients with preexisting medical conditions, when short treatment times are indicated. 7–12 The final treatment result and subsequent restoration of enamel defects.

CLINICAL PEARL

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Jul 7, 2020 | Posted by in Orthodontics | Comments Off on Recontouring of Incisal Edges
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