Veneer Treatment Considered Together With the Face

Hello, I'm Park Jonguk, director of Dream Dental Clinic.

Almost no one's face is perfectly symmetrical.

You can assume that almost nobody has a completely symmetrical face.

This is true not just of the nose, lips, and jaw, but of the teeth as well.

The shape of individual teeth is mostly symmetrical,

but in many cases, things like their alignment and angle are heavily influenced by the jawbone as well as by the teeth themselves.

For this reason, having perfectly symmetrical teeth isn't easy.

The ways to correct this kind of asymmetry

include orthodontics and orthognathic (jaw) surgery.

Since orthodontics and surgery both involve significant cost, time, and discomfort during treatment,

they aren't easy decisions to make.

Surgery in particular carries considerable risk,

so unless the asymmetry is severe,

even as a doctor, I find it hard to readily recommend it.

With veneers, which is the area I work in,

there are cases where this kind of asymmetry can be improved to some degree.

For a small amount of asymmetry, meaningful improvement is possible.

The problem is that, in many cases, veneer treatment is carried out

without recognizing the asymmetry of the face as a whole.

Even patients who do have asymmetry often don't realize it themselves

until I go through the diagnostic process for veneers,

and are sometimes surprised when they see the diagnostic photos.

Checking the positional relationship between the whole face and the teeth like this before treatment is extremely important.

And it needs to be factored into the treatment plan.

The teeth were slightly misaligned,

the lateral incisors next to the front teeth were small,

and to resolve areas that looked dark due to excessive translucency in the teeth,

we decided to proceed with veneer treatment.

Because the front teeth protruded fairly noticeably, we also considered whether orthodontic treatment would be needed.

But the issues to be resolved — not only the tooth alignment, but also the peg-shaped tooth and the translucency of the teeth —

couldn't all be resolved through orthodontics alone,

so we decided to proceed with veneer treatment.

Looking only at the teeth, this looks like a simple veneer case,

but when you look at it together with the face, you can sense the asymmetry.

Looking at the whole face, you can see that the teeth are tilted quite noticeably.

The patient herself hadn't been aware of this tilt.

Through veneer treatment, not completely,

but we decided to correct the tilt to a meaningful degree.

The treatment plan is built around this tilt.

From the very start, we proceed with the diagnosis

on the assumption that the teeth are tilted.

Aside from the protruding front teeth, we decided to proceed without reducing the other teeth at all.

We shape the teeth in wax to rotate the tilted angle slightly,

and the amount of tooth reduction is decided to match.

We proceeded through tooth reduction and the fabrication of temporary teeth.

Since this treatment is meant to correct the tilted state,

the teeth on the left generally need to become shorter overall,

and the teeth on the right need to become longer.

Only then does the tilt actually get corrected.

But if the teeth on the left are simply shortened, symmetry between the teeth won't be right,

so the shape of the gums needs to be adjusted as well.

There are two ways to adjust the gums, depending on how much adjustment is needed.

One is to actually trim the gum tissue using a laser,

and the other is to take an impression by pressing on the gum, and then naturally raise the appearance of the gumline through the shape of the ceramic.

In this case, we used the second method

to correct the shape of the gums.

Both methods have their own pros and cons, so we choose depending on the situation.

A beautiful set of veneers was completed.

Without completely removing the translucency of the teeth,

we left it in naturally

while enlarging the lateral incisor to some degree to match the proportions.

Even viewed from the side, all of the teeth

blend together well without irritating the gums,

as you can confirm here.

By recreating even the beautiful texture on the surface of the teeth,

a natural tooth shape was achieved.

What matters especially in this case is comparing the smile before and after.

You can see that the once-tilted, awkward smile has been straightened out.

With the reduction of just a single tooth,

the symmetry of all 8 teeth improved,

the smile became more beautiful,

and the patient gained confidence.

Since 2006, Dream Dental Clinic