Beautifully Reshaped with Resin for Peg Laterals, Without Tooth Reduction

As winter break begins, more and more people are coming in for consultations for front tooth treatmentㅎㅎ

When consulting on front teeth, I often see patients with peg laterals.

According to research, peg laterals are reported in about 1–3% of the general population, so they are a very rare case, which makes it especially rewarding that we see so many at our clinic^^

This patient was a woman in her 30s, with only one of the second front teeth being a peg lateral. In addition, there was a fracture in one of the central incisors.

The fracture was caused by malocclusion.. so for a fundamental solution, I recommended orthodontic treatment.

However, considering the long treatment period, financial burden, and her current living situation, she wanted a quick solution.

She said, “I want a simple solution with resin,” so I’ll show you a case where both the peg lateral and the fractured front tooth were treated with resin without tooth reduction.

A small tooth was changing the overall impression.

After examination, the upper right lateral incisor was a typical peg lateral, while the opposite lateral incisor was normal in size and shape.

The problem was not simply that the tooth was “small,” but that the balance between the two sides was disrupted.

Just as with a person’s face, teeth look natural when the left and right sides are similar. If only one side is unusually small, the other areas can look larger or the arrangement can appear irregular.

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The fractured upper right central incisor was in a position where it hit the lower front teeth that were tilted, every time the bite closed.

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Because it was receiving so much force, the edge of the tooth had no choice but to chip.

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Also, both teeth were tilted toward the palate.

Taking that into account, we planned to build them out toward the front so they would look fuller and appear overall more aligned.

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When looking only at the left and right central incisors, the gum line was asymmetrical, so I recommended doing gum contouring as well.

For the fractured front tooth, I offered two options.

Treatment method
Resin for the fractured front tooth + bite adjustment of the lower front teeth
2. Tooth reshaping of the fractured front tooth + gum contouring

The patient said she would first treat the fractured front tooth later and decide after treating the peg lateral, but after the peg lateral resin treatment, she asked to treat the fractured tooth as wellㅎㅎ

I first thought about how to change it without shaving it down.

The first thing I always consider in front tooth treatment is this:

“What is the most conservative way to do this?”

Once a tooth is shaved down, the available options are greatly reduced afterward.

I decided on resin, which can treat the tooth without touching it.

Peg lateral resin

For the peg lateral, I built up the size with a direct peg lateral resin veneer based on the size and shape of the opposite lateral incisor as closely as possible.

For the fractured front tooth, instead of just filling the broken area, I planned to refine the surface as if veneering it with resin so that the overall line would continue naturally.

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This was not a treatment that made a big change all at once, but a process of making small adjustments, only as much as needed.

I also explained to the patient, “I’ll make it look as natural as if it had always been this tooth.”^^

If it feels like a simple patch, that is a failure.

Peg lateral resin is usually thought of as simple, but it takes much more work than it looks^^;

If you build it up too much at once, the shape may come out quickly, but it can come off just as quickly, and it is more likely to be noticeable when light hits it.

That is why, for peg lateral resin, I gradually build it up little by little while constantly comparing it with the opposite tooth and matching the shape.

I carefully shaped it by checking everything one by one, including the width, length, the curve of the sides, and even how it felt when touching the adjacent tooth.

I also paid close attention to refining the surface with resin so the front teeth would look neatly aligned in one line.

It took a little more time, but without this process, the result would never look naturalㅎㅎ

We finished the treatment naturally without tooth reduction using peg lateral resin.

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After the peg lateral resin treatment was finished, the patient looked in the mirror and immediately said,

“It really looks seamless.”

At first, she had wondered whether the fractured front tooth really needed treatment, but two weeks later she came back and decided to treat itㅎㅎ

She chose the first option I mentioned, so after the front tooth resin treatment, we also adjusted the bite of the lower teeth.

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Cases like this make me even more certain that front tooth treatment should never focus on just one area, but always consider the whole picture.

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Not all front tooth treatment needs to be a major reduction procedure like a crown or veneer.

Depending on the case, there are certainly options to improve the shape with resin treatment without removing any tooth structure.

Whenever I treat a patient, I spend enough time planning carefully and aim for minimal reduction and natural results whenever possible.

If you are considering front tooth treatment, please feel free to consult about the treatment method that fits your current dental condition.

This has been Sohyunsoo, director of Jaejulgood Dental Clinic. Thank you.

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• Depending on the individual, symptoms such as discoloration or detachment may appear temporarily, and in rare cases additional procedures may be necessary.

Treatment period: 251120 - 251120