Treatment Process
This patient presents with the specific concern that he has “spaces” (called diastemas) between his teeth. He states that he did have orthodontic treatment years ago, and did not have the spaces until recently, and had stopped wearing his retainers for years. He does mention that the spaces have gotten larger.
Close analysis of the patient’s bite indicates that he has a habitual forward posture that has caused his teeth to “shift” after wearing his orthodontic retainer. Evidence of tooth wear also indicated that he has been “grinding” his teeth, likely during sleep. Treatment options to correct this esthetic imbalance include the following: Retreatment with orthodontics, definitive treatment with porcelain veneers, or long term stabilization with composite bonding. Because the patient has experienced some minor tooth wear from tooth grinding, restorations of some type were indicated to address this problem, even if orthodontics was done. In this situation, orthodontics would be of limited benefit. This patient chose to whiten his teeth, and then restore with composite bonding.
Results of home whitening and bonding.
Close up bonding.
Before/After retracted view.
