In dentistry we have a name for the area of the mouth consisting of the front six to eight teeth. We call this area the "aesthetic zone". This is because it is so important for your smile; these teeth are your "money makers". They are the teeth people see when you talk, eat, smile, and laugh. Having a problem with just one of these teeth can compromise your whole smile. Often people don't realize how important these teeth are until something happens to one of them and they come in saying they look like a hillbilly. Because the aesthetics of these teeth are so important, implant placement in the aesthetic zone is incredibly challenging. When people look at these teeth they like to see symmetry, the left side should look just like the right side. If it is off just a little bit it is noticeable, even if people can't identify what it is that is unaesthetic. Some common challenges we encounter when placing implants in the aesthetic zone are:
Inadequate width of bone, which makes it challenging to place an implant where we need to in-order to get the appearance that the tooth is emerging from the gums, as a natural tooth does,
Inadequate height of bone, which can result in your implant tooth looking longer than your other teeth,
Difficulty maintaining the gums that scallop in-between your teeth, resulting in a "black triangle" or a gap between your teeth at the gum line.
When a patient comes in with a problematic front tooth, the first priority should be fixing the aesthetic issue. Of course we also want to address the functional problem (i.e. replace the tooth so that you can chew with it), but usually patients are OK with avoiding chewing on an area for a little while. No one wants to be missing a front tooth. The technology we have today is amazing. With CAD/CAM and implants, you can walk in with a broken tooth, and walk out with an implant supported temporary crown the same day!
Do you have any questions? Any other topics you'd like me to address on this blog? Shoot me an email at firstname.lastname@example.org and I'll either respond with an email or with another blog post.
Jonathan Geleris, DDS, FICOI
Disclaimer and disclosures: I'm a dentist who performs dental implant treatments, and general dentistry in Walnut Creek, California. I don't work for any dental companies (other than my practice). Nobody pays me to write this. As much as possible, I hope to present factual information supported by solid science, however, humans are complex, and the science in this field is constantly evolving. Some of what I present may be based on my opinion.