Resin Treatment for Peg Laterals: Re-Treatment of Teeth Done 20 Years Ago, Then the Opposite Side Too

Peg laterals treated with resin 20 years ago

Re-treatment of the teeth, then the opposite side too

Peg lateral incisors usually occur on both sides.

But sometimes, for various reasons, people say they want to treat just one side first.

However, once there is something to compare it with, that is all you can see from then on.

So in the end, many people end up treating both teethㅎㅎ

This patient was the same. They first had re-treatment of the right peg lateral with resin, and were happy with the result, so they said, “I’d like to treat the left peg lateral too.”

The hidden threat inside 20-year-old resin: a sign of not just discoloration, but ‘secondary decay’

There was an old resin restoration on the right peg lateral. The patient said it had been there for about 20 years.

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On examination, the resin was partially fractured, and secondary caries was also suspected underneath.

With the passage of time, margins can weaken and microscopic gaps can form.

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And this was not just a matter of re-treatment; both were original peg laterals, and both were slightly set inward.

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Also, although the patient had undergone orthodontic treatment and was wearing a retainer, the front teeth were slightly spaced apart.

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When asked, the patient said it was because of a tongue-thrusting habit.

Since they said they did not want treatment for the gapped front teeth, we decided to treat only the peg laterals.

The right side up to the gum line, the left side with minimal intervention: “only as much as needed”

On the right, the key was re-treatment + adjusting the proportions, while on the left the goal was to match the symmetry with peg lateral resin.

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However, the important thing is not to do the exact same thing on both sides no matter what.

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This is how I always think about front tooth treatment.

• Even for the same front tooth, the method should differ if the situation is different.
• The goal is “symmetry,” not “copy and paste.”

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So on the right side, we removed the existing resin, cleaned up the inside, and decided to combine the procedure with gum contouring to shape the gum line as well.

On the left side, the patient said, “I couldn’t even notice the opposite side until the doctor pointed it out,” so we decided to proceed with only the right side first.

Re-treatment has to be more delicate than doing it from scratch.

On the right side, we first removed the existing resin/material. The important thing in this process is not to “take it off quickly and fill it quickly,” but to carefully clean it until the margins are neat and clear.

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After removing the secondary decay, we checked the internal condition again, cleaned up any necessary areas, created a clean foundation, and then moved on to the next step.

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Then we performed gum contouring. Gum contouring is not simply about making the gums look prettier; in front tooth treatment, it is essentially the work of setting the tooth’s length and proportions.

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For peg laterals or small front teeth, simply widening the tooth can actually make it look more awkward. When the gum line is properly adjusted, the tooth achieves a better length-to-width balance and looks much more natural.

A phone call two weeks later: they wanted the opposite side done too

Two weeks later, the patient was scheduled for a checkup and went home, but called before the appointment date.

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I have an appointment two weeks from now,

and I’d like to treat the opposite side then.

After the treatment, I kept looking in the mirror,

and the asymmetry kept bothering me~

The left peg lateral resin treatment was done without gum contouring, and the treatment was done with resin only.

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The point here is not to make the left side exactly like the right side, but to make it look natural, as if the left tooth had always been that way.

In most cases, peg lateral resin treatment is more natural and aesthetically pleasing when approached as “tidying it up so it blends with the surrounding teeth” rather than “making it bigger to match.”

The place that adjusts even the subtle color and height is the real thing.

Treatment is not over just because it is finished. Front teeth are where people are especially sensitive to tiny differences.

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This is where the advantage of resin comes in. Unlike a crown, which is fixed all at once, resin allows for fine adjustments and polishing to improve the final quality.

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That is why I think of peg lateral resin treatment not as a process that ends all at once, but as a treatment where we refine the finish together.

When I treat front teeth, my goal is not to make big changes no matter what. Rather, I think it is most important to make only the necessary changes accurately while prioritizing preservation of the natural tooth.

Creating a result that makes you feel comfortable smiling by shaping only what is needed, without overbuilding it—that is the direction I value most in front tooth treatment😄

This has been Dr. Sohyun Suh of Rejagjo-eun Dental Clinic. Thank you.

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