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Procedures

Cosmetic restorations, one tooth

Procedure overview

Learn about the dental procedure, when it is generally prescribed, and other information which can increase your knowledge of the topic.

Cosmetic restorations are done to improve the appearance of the teeth. There may or may not be other reasons for doing them, such as tooth decay, chips (Figures 1a and 1b) or cracks. Cosmetic restoration of a single tooth is achievable with modern dental materials (even in highly visible areas of the smile). It is possible to re-create the shade, transparency and optical characteristics of natural tooth enamel, although it can be challenging.

Because of this, patients are sometimes encouraged to have crowns or veneers placed on two, four or even more teeth when only one is involved. It is sometimes true that the overall appearance of the patient could be enhanced with multiple restorations; however, if only one tooth is a problem, matching it to the others to the satisfaction of the patient is usually achievable.

Single tooth repaired with composite resin ("bonding")

A large anterior tooth chip sustained playing hockey with no athletic mouth guard

Figure 1a: Over half of this tooth fractured when the child was struck with a hockey stick. The restored tooth is shown in Figure 1b.

Bonded repair using tooth-colored composite resin filling material

Figure 1b: Due to the child's age and tooth development status, the injured tooth was restored by directly bonding composite resin material to its remaining clinical crown, which provided acceptable esthetics. Although it sometimes occurs in this type of injury, the root canal was not exposed, the tooth did not die, and at the time of this compilation, the composite bonding had been successful for seven years.

Typical materials used for cosmetic restorations include solid porcelain, porcelain fused onto a zirconium strengthening core (zirconium is a white metal), porcelain fused onto metal (e.g. gold alloys), and composite resin. Cosmetic restorations include veneers, crowns, bridges, and fillings.

Cosmetic excellence should be the goal of any dental restoration, although in areas which are not visible, function should definitely be the priority. As an example, upper second molars are typically not visible to anyone but dental professionals, and the demand for durability in that location should outweigh the importance of cosmetic attributes. Gold crowns are commonly prescribed for upper second molars, because they are not usually visible, will not chip, and require less tooth removal than ceramic crowns.

Cosmetic results are a priority when visible teeth have been chipped or cracked, or when they are missing or poorly aligned. They are also prescribed for teeth that are discolored or non-uniform.

Single crown on a front tooth

A single ceramic (porcelain) crown can be very esthetic even on front teeth

Figure 2: An injury to the patient's front left tooth led to the need for a crown. A single crown was placed, which provided the excellent cosmetic result shown in the photograph.

Single crown on an implant

Dental implant restored with porcelain crown for congenitally missing lateral incisor tooth

Figure 3: This patient's upper left lateral incisor tooth was missing from birth, a fairly common occurrence. Space for the missing tooth was created orthodontically (i.e. with braces), a dental implant was placed and restored with the crown shown in the center of this photograph. The teeth on either side of the implant were not touched, and a beautiful esthetic result was achieved with just one crown.