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Figure 5: The areas that need to be reshaped as determined on the
preoperative cast are marked prior to preparation.
Figure 6: The provisional stents in place to be used as preparation
guides to evaluate for proper tooth reduction.
Figure 7: A maxillary arch incisal view of the completed case. Compare
the postoperative arch form to the preoperative view shown in Figure 1.
Figure 8: A retracted facial view of the completed case.
Figure 9: An eight-year postoperative view of the completed case.
For a select group of
patients with minor tooth
malposition … esthetic and
functional correction may
be accomplished purely by
restorative means.
If the case is determined to be reasonable to perform, the
patient must then approve the mock-up to ensure that the
proposed correction will meet his or her expectations. If desired,
the actual teeth can be marked in the same fashion as
the study models using a sterile marker to show where the
teeth need to be reshaped prior to depth-cut placement and
tooth preparation for the restorative material (Fig. 5). Clear
provisional stents made from the composite mock-ups can
also serve as three-dimensional preparation guides to verify
proper tooth reduction (Fig. 6).
A completed incisal view and full-smile retracted view are
shown in Figures 7 and 8. Compare these to the preoperative
views (Figs. 1, 2) to visualize prosthetic corrections.
Figure 9 is an eight-year postoperative, full-arch, retracted
facial view. This case has been esthetically and functionally
stable over this period of time.
Prosthetic Tooth Repositioning: A Viable Treatment Option for Select Cases57