Orthognathic Surgery Alternative
Video: Orthognathic Surgery Testimonial
Failed Orthodontics - Open Anterior Bite
Traditional orthodontic treatment typically requires a few years of treatment to produce beautiful straight teeth.
The process of constantly and carefully realigning individual and groups of tooth structures can have very dramatic effects for dental function, and of course, dental cosmetics.
At first glance, the adjacent photo of our young patient seems to represent a successful orthodontic treatment result for the 2 years she had been treated.
Unfortunately, although the patient has a great looking smile, she has an anterior open bite. This type of bite problem is a condition where the front teeth do not close down far enough on the lower (mandibular) jaw.
When the patient first came in for a consultation, she expressed frustration with being able to close her mouth. When she smiled broadly, her tongue was always visible. She was very self conscious about smiling and careful about showing her tongue.
Our patient had consulted with several cosmetic and reconstructive dentists... in Alabama and Georgia. The recommendation was always the same... undergo orthognathic jaw surgery to reposition her lower jaw as needed to create the bite relationships that should exist for her particular jawbone structures.
As many as 20 porcelain veneers were also recommended to produce the final cosmetic result of having adult sized teeth on both the upper and lower (maxillary and mandibular) jaws. Invasive jaw surgery and almost a full mouth of veneers, however, didn't appeal to the patient.
Seeking Orthognathic Surgery Alternatives
A thorough examination of the patient's bite characteristics was conducted and reviewed in detail with the patient to establish the precise cosmetic goals that were being sought. Although orthognathic surgery is required in many instances where bite problems are severe, it was determined that the physical size and shape of certain tooth structures could be altered that would establish a normalized anterior bite.
Some of the patient's tooth structures had an excess of gingival tissue, creating the appearance of having small teeth. Laser gum recontouring and crown lengthening can be used to reduce the gummy appearance of the patient's smile, producing a much broader and whiter smile.
Although porcelain veneers are a popular treatment to create larger appearing teeth, for many patients laser treatments can be safely used to expose more of the tooth structures.
The adjacent photo shows how gum tissues were changed on the upper arch. By looking closely at this photo and comparing it with the preceding photo, it can be seen how more height is created for several teeth. Six of the upper anterior (front) teeth will be fitted with custom veneers.
Bite Reconstruction via Custom Veneers
Changing the physical dimensions of individual tooth structures is possible through the use of custom veneers.
A premium dental lab can create veneer products that not only enhance the cosmetic outcomes of treatment but can be fabricated with different thicknesses to produce wider tooth structures.
Performed on a tooth by tooth basis, with extensive use of an articulator (device for assuring proper bite and occlusal relationships), the custom six veneers created the larger and broader biting surfaces that resulted in a normal alignment with the patient's lower teeth.
The final cosmetic result exceeded the patient's expectations. Her upper teeth looked and felt very natural. In terms of functional dentistry, the patient reported having a more comfortable bite. The reduction of gum tissue created a very appealing smile.
The last photo shows the impact of the cosmetic and functional changes achieved.
Total treatment time was approximately 2 weeks... in contrast to what could have taken (with orthognathic surgery) up to 2-3 years to complete.
Non Invasive - No Prep Veneers
Outside of the laser gum contouring, invasive procedures were practically non-existant. Thin shell feldspathic porcelain products were used to alter the physical characteristics of each tooth that was treated.
No excessive and/or unnecessary tooth preparation was performed.