Minor Tooth Movement for Esthetics vs. Comprehensive Orthodontic Care

How often have you had patients come in and ask if you could just straighten one tooth to give them a better-looking smile? It’s a fact that most adults are unwilling to undergo complete orthodontic care. Yet, many of them would love you to do something to improve the way their teeth look. Fortunately, there are many minor tooth movement procedures that you can do that will give your patients the esthetic result they are looking to achieve. In this, and succeeding issues of Aurum Ceramic/Classic News, we will explore some of the more common orthodontic procedures used every day to help you give your patients the beautiful smile they want.

This female patient presented with a bilateral posterior crossbite due to an underdeveloped maxilla that was not treated at an earlier age. She also had a blocked-out lingually placed lateral incisor. After a thorough examination by an orthodontist, it was recommended that because of her age, she undergo maxillary surgery and complete orthodontic care to correct her skeletal cross-bite. Although this was an excellent treatment plan, it did not take into consideration the patient’s desires. All she wanted was to straighten out the one blocked-out lateral to improve her smile.

Because her cross-bite was not causing any functional problems (i.e. TMJ dysfunction or improper mastication) and her periodontal health was excellent, a minor tooth treatment procedure was done that gave her the esthetics she desired. A combination fixed/removable swing lock retainer was used. This appliance allowed the cuspid to be brought back distally using an elastic force into a space created by a small amount of enamel re-contouring. Once that was accomplished, the rest of the space needed to move the lateral into position was gained by opening the swing lock expansion screw and enamel re-contouring the mesial of the cuspid, mesial and distal of the lateral and the distal of the central. This combination of movements allowed the space to be gained for the blocked-out lateral without disturbing the occlusion or removing an excessive amount of enamel from the adjacent anterior teeth. The lateral was then moved into position using a re-curved spring.

This minor tooth movement took less than four months to complete. Once completed, the active appliance was used as a final retainer. Notice that the patient has bleached her teeth. It is not uncommon for patients who have undergone a minor tooth movement procedure to follow it up by bleaching their teeth.

Facial view of an adult patient with a bilateral posterior crossbite and a blocked out lateral.		Occlusal view clearly shows the blocked out lateral that is the patient’s main concern.
The appliance used was a swing lock retainer with a recurved spring.		Occlusal view in treatment. Space has been gained and the lateral was guided labially.
Facial view of the completed treatment.		Occlusal view of the completed treatment.