This lovely patient had unfortunately broken a tooth in her smile during lockdown. There wasn't enough tooth remaining to build it back up and the root had a split in it, so unfortunately we had to plan to remove it. She had a tooth missing behind the broken tooth which was replaced with a false tooth attached to the first molar tooth by a crown. The tooth to the front had no fillings or treatments.
We made plan to do an immediate fixed bridge after the tooth was removed so that her smile could be restored straightaway. This involves taking the tooth out carefully with as little trauma to the gum as possible, placing a rubber dam (a plastic sheet over the teeth) to keep everything dry and gluing a metal wing on the back of the canine tooth (pointy one in front of the gap) to hold the new tooth. This tooth can be modified in the future when the gum changes shape as it heals. It can be permanent in some cases or act as the pretreatment to implants in the future. In this case we could consider replacing the crown on the first molar with a beautifully aesthetic crown and have implants to replace the two tooth gap. This patient will decide what is best for her in the future. But for now we have provided a her with an immediate aesthetic result that gives her some confidence while she heals.
The picture below shows the after immediately after fitting. With thanks to Matt Hammond for the beautiful lab work.
Options for tooth gaps:
Leave the gap.
A fixed bridge - a bridge spans a gap either attached to one tooth, two or three and can be attached by a wing or by crowning the teeth.
A removable bridge or denture - an appliance that fits in the gap and is held in place by suction or clips but which can be removed. It is supported by the gums and teeth.
Implants - a gold standard in tooth replacement where a special device or "screw" is placed in the bone to act like a tooth root and the replacement teeth are built on this framework.
There are pros and cons to each option and I would be happy to discuss your case with you if you want more information.
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