Difficult case

Adi

Adi

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Hi
What are the options to reshape the smile of this young lady? IMG_20191130_230331.png IMG_20191130_230145.png IMG_20191130_230106.png
 
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millennium

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She needs perio surgery. Some bone augmentation. Got to lift that gum by at least 3mm
 
Flipperlady

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I would ask her how she feels about the way she looks. What does she want to accomplish from this? Personally , I think making the teeth themselves the best they could be should be enough, the rest is just being unique (I hate "perfection" to be honest). If the pt. is fine with teeth cleaned, brightened, repaired, and say it's the mother who has the problem, then I would refer to a counselor before staring something too drastic.
 
Tayebdental

Tayebdental

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Needs orthodontic treatment before you start, #10 overlapping is excessive and so is # 7 in a lesser sence
 
millennium

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Needs orthodontic treatment before you start, #10 overlapping is excessive and so is # 7 in a lesser sence
If the ortho option is being used the orthodontist might move the centrals up and the bone and gum will follow.
 
Tayebdental

Tayebdental

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There are limitations to what you can do to improve this case, specially if ortho treatment and tooth lengthening are skipped.
 
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2thm8kr

2thm8kr

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The incisal edges of the centrals are right where they need to be lengthwise according to the smile line. The canines are a little to far into the smile line. If you do crown lengthening on this patient the length to width ratio will be off significantly for the incisors. If Ortho is chosen to intrude the teeth what happens to the patient's occlussion and guidance?

Do a diagnostic work up either digitally or traditionally to help find the best approach to solve this case. This is the only predictable way to make any useful suggestions.
 
Tayebdental

Tayebdental

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A diagnostic wax up will help if you are at some liberty to adjust teeth in this case/ model to achieve improvements
 
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