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Misaligned and Crowded Teeth

Procedures

Misaligned teeth are usually corrected by orthodontic treatment, which often takes two or more years and involves the bonding of braces to the tooth surfaces, which are then connected to wires and rubber bands to create the light forces necessary to slowly move the teeth into the desired position. Orthodontic appliances are usually very visible. After the completion of the tooth alignment, a patient often has to wear a retainer for the rest of his life to maintain the established position of his teeth.

In certain cases, cosmetic dentistry may be a valid choice to correct misaligned teeth invisibly and quickly (it usually takes only two to three weeks). If your teeth are only slightly misaligned, extensive orthodontic treatment may not be necessary and a minor cosmetic correction by placing ceramic veneers or porcelain crowns may handle your situation perfectly. Orthodontic retainers will then not be necessary. Often teeth are not just misaligned but also have defects on their surfaces or worn incisal edges. In many cases, porcelain restorations would be necessary to rebuild those damaged teeth. Since varying porcelain thicknesses of veneers can mask slight misalignments of teeth, orthodontic alignment may be unnecessary. In addition, there will be no need for wearing a retainer once the treatment is completed. While conservative procedures, such as such as orthodontics, bleaching, direct bonding and enamelplasty are always the treatment of choice, porcelain veneers may be an excellent option to address damaged and aged teeth that are only slightly misaligned.

In any case, a thorough analysis of the condition of the existing teeth, their functional relationships in the oral cavity, as well as the condition of the masticatory system, are indispensable. This includes a through analysis of the health of the mandibular joints, the properly mounted dental models, and trial treatments, such as dental diagnostic wax-ups. This will help the cosmetic dentist to get a good idea about what can be achieved and how invasiveness of a dental procedure can be minimized.

misaligned teeth in cosmetic dentistrystraighter teeth in cosmetic dentistry
This patient was only interested in getting her lower teeth straightened. She is a public figure and not interested in wearing braces and retainers. Two weeks after the initial preparation of her teeth, she received six Empress veneers. They were bonded with dentin-bonding agents and a composite luting cement.
misaligned teeth before cosmetic dentiststraightened teeth after cosmetic dentist
This patient never liked her dominant "Bugs Bunny" teeth and decided to do something about it (left). She received 10 upper porcelain veneers to make her teeth look straight, get them into proper proportions, and to make them brighter and appear more youthful (right). She became very emotional, when she saw her new teeth. She stated (with tears of happiness in her eyes),"I wished I had done it many years ago, when I was younger!"
crowded teeth before smile makeoverstraighter teeth after smile makeover
This patient had an incompletely erupted canine and an irregular gum line (left). She was not interested in any orthodontic extrusion of the tooth. She received adjustive gum surgery and a total of six porcelain veneers. Note the healthy and equilibrated gum line and an apparently "fully erupted" canine (right).

References:
Tipton PA1. Aesthetic tooth alignment using etched porcelain restorations. Pract Proced Aesthetic Dentistry 2001 Sep; 13(7): 551-5.
Lowe RA1et al. Indirect laminate veneers: an excellent option to correct elective aesthetic problems.. Dentistry Today 2000 Aug; 19(8): 84-8.
Radz GM. Minimum thickness anterior porcelain restorations. Dental Clinic North Am 2011 Apr; 55(2): 353-70.
Peumans M et al. J Dent. Porcelain veneers: a review of the literature. 2000 Mar; 28(3): 163-77.