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).
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.