Full smile after gap closure ?


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May 20, 2020
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hi, many years ago I lost my upper front incisor next to my canine tooth & gap closed thus I don't have a full smile . what options would I have to incorporate the missing tooth back to create a full smile and is it possible ? have spoken to a clinic in turkey and they said they would crown my upper front teeth & incorporate the missing tooth thus creating a full smile again . is this possible ? any help at all would be great thanks .
 
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honestdoc

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Please include images. The canine provides for facial profiles and orthodontically moving the canine can be difficult. Crowning can introduce a lot of pitfalls especially if your bite is not stable.
 
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Hi honest doc Thanks for taking the time to reply I have enclosed some pics & as you can see my teeth aren’t great. The dentist I spoke to in turkey is highly recommended & she reckoned she could incorporate the tooth that’s missing. I also spoke to her about doing a full makeover for upper & lower jaw ie 26 crowns she mentioned. My bite isn’t great at the minute as accasionally I bite my tongue .... would having work done improve this ? And do you think the work mentioned is possible. Thanks rob
 

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honestdoc

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Could you provide an image with your natural bite? I'm not sure how your dentist will add a tooth that is missing. The canine had drifted into the missing space. Your case will be very challenging to correct the midline and accommodate a potentially destructive biting patterns. If you will be investing in your treatment, hopefully your dentist will provide a "mock up" of you teeth for you to review. There will be a lot of work to reconstruct your teeth. I would recommend a prosthodontist specialist.
 
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hi thanks for taking the time to reply I have my concerns how its going to be possible to incorporate the missing tooth. have sent pictures over to dentist in turkey and she said no problem she will forge it the missing incisor ? she also mentioned adjusting the front side to incorporate missing incisor ? have enclosed pics of bite . really grateful for your help . thanks
 

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honestdoc

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You have both Left & Right posterior crossbite. I would recommend seeing a crown and bridge specialist (prosthodontist) because any work may have a high chance for failure like broken crowns, TMJ problems and pain, and unpleasing esthetics. It's going to require a lot of work and expense. Only go for the experts (expensive). If you go cheap (less experienced, short cuts) it will fail miserably or just leave it alone.
 
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the dentist in turkey seems highly experienced and quoted a price of £4000 which was 26 crowns. in your opinion would you say to leave things as they are ? would an upper jaw implant be a good option ? sorry for all the questions but I don't want to spend a lot of money to create problems for myself . thanks for your help
 

honestdoc

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What was your reasoning for treatment? As long as all your teeth have no cavities, and your gums and bone are healthy, I would leave it alone. 1) Your dentist will have to drill on your teeth to put crowns in. When the dentist drills on your teeth, the nerve (pulp) gets traumatized and you can have a lot of sensitivity afterwards. 2) Your bite is in crossbite. That means the dominant areas of your teeth are in different positions and when you chew, it can place a lot of stress in awkward pressure points. When you have tooth colored (porcelain) crowns, the porcelain can get cracked and damaged due to the awkward pressure points. Once the dentist starts to mess with it, there is a high risk of problems I've mentioned.
 
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hi, the only reason was vanity I suppose and to try and create a full smile. the dentist in turkey mentioned she would use zirconia crowns which are stronger and more durable by all accounts. in my online research dentistry in turkey seems more advanced than in the uk would that be true ? going to have a long think about this as don't want to create any major problems. would an upper mouth implant be an option or is that still going to create problems ? thanks for all your advice
 

honestdoc

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I'm in the US. Zirconia is a very strong product with 2 disadvantages from my observations. 1) Zirc is not as esthetic as eMax although modern Zirc have improved. 2) Zirc can still crack. It is a hard decision. Have your dentist do a mock up of your ideal smile (you may have to pay for the labor).
 
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honestdoc

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thank you your help is much appreciated. just a final question …. would mouth implants be an option or would I still have problems ? thanks

Implants are great for missing teeth. I didn't notice you having missing teeth other than the front incisor being closed by the canine. Having implants can be tricky. I've seen many implants fail with bone damage. I recommend it be done by an experience surgeon and restored by an experience implant restorative dentist.
 

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