Congenitally missing lateral incisors
Congenitally missing lateral incisors, both of them, Allie was faced with tackling a major cosmetic problem that affected her smile and her face. Her orthodontist straightened her teeth and when her braces came off at age 14 he attached two “false teeth” to her retainer. Thus when she wore her retainer it appeared that she wasn’t missing any teeth, but that meant she also had to always wear her retainer. Her orthodontist’s strategy was that at an appropriate age Allie could get dental implants or bridges. Over the next three years Allie got very tired of wearing her retainer all the time. The “false teeth”, although looking better than having no teeth there, didn’t look good. It was obvious to those who looked at her that they weren’t her “real teeth.”
Finally, as a seventeen year old senior high school senior, Allie came to us to discuss what options she would have to give her some “permanent teeth” before she went away to college. Along with her parents, Allie was thinking that dental implants would be the way to go to replace her congenitally missing lateral incisors. Unfortunately there were two reasons why dental implants would not work in Allie’s case. First, there was not enough room in the bone to place a dental implant. The area between the adjacent teeth on both sides where the tooth was missing needed to be wide and thick enough for the implant. It wasn’t! The second reason is that her orthodontist could not confirm with certainty that all of her vertical facial growth had been completed. If an implant is placed and the patient is still growing, then the natural teeth and gums grow with the face, but the dental implant does not! A horrible esthetic result could occur. So dental implants was not the solution to correct Allie’s congenitally missing teeth problem.
Fortunately there was a permanent solution to Allie’s congenitally missing lateral incisors problem. Since she was missing two teeth, she could have two dental bridges. The conventional type of dental bridge is a porcelain-fused-to-metal bridge, and this requires that her adjacent teeth be shaped to accept dental crowns that anchor the false tooth in place. Since Allie had beautiful teeth without any cavities, blemishes or flaws whatsoever, it would be very hard for both the patient and cosmetic dentist to justify shaping those teeth to accept crown coverings.
Conservative bonded winged bridges were the solution
But the great news is that in Allie’s case she did not have to have conventional dental bridges! She was a great candidate to take advantage of modern, ultra conservative bonded cosmetic dentistry. Allie could get two bonded bridges that would not require that the fronts of the adjacent teeth be shaped or prepared in any way. Other names for this conservative type of bonded bridge are “bonded winged bridges“, “non-metal Maryland-type bonded bridges” or “lingually retained bonded bridges“.
The main point here is that as an Orange County cosmetic dentist treating Allie with new techniques I did not need to drill any of the front surfaces of any of Allie’s teeth to accept the lingually retained bonded bridges. These conservative types of bonded bridges can be done with just very minimal tooth preparation on the back sides (dental term “lingual”) of the adjacent teeth. The new bonded bridges are made without any unsightly metal (as the old type of “Maryland bridges” were), and are fabricated completely from natural looking tooth colored materials which are bonded onto the back sides of the teeth with the dental curing laser.
Allie and her parents were excited that we could offer her this new strategy of conservative bonded cosmetic dentistry. They absolutely loved the fact that her natural teeth didn’t have to be drilled (shaped) to accept crowns that covered the entire tooth. They also were thankful that we were able to give her a permanent solution and at the same time circumvent her treatment without the need for surgical dental implant treatment.
Just a note here: We are strong advocates of dental implants, use them often in our practice, as dental implants are in many situations the best treatment choice for the patient. However, most cosmetic dentists will agree with me that in Allie’s case it was not the best treatment choice.
And, the results for Allie congenitally missing later incisors treatment ? Absolutely beautiful! No description necessary, see the photos and see for yourself. This beautiful young lady from Orange County is now away in college enjoying her freshman year without showing that she’s congenitally missing her lateral incisors.