Partial Orthodontic Treatment for Anterior Teeth with No-Prep Laminates for a Patient in Their 60s

Hello,

Apgujeong no-prep laminates

This is an orthodontic clinic in Apgujeong.

There are quite a lot of cases where laminates are needed after orthodontic treatment. In particular, if there are peg-shaped teeth among the front teeth, it is difficult to achieve proper anterior bite alignment without laminates.

So, after orthodontics is used to adjust the space so that laminates can fit in with a harmonious size, it is common to refer the patient to a prosthodontist or a general dentist for laminates once orthodontic treatment is finished. Even now, many orthodontists proceed that way.

However, the orthodontist is the one who has communicated with the patient throughout the orthodontic treatment period, and therefore it is also true that the orthodontist can better reflect the patient’s needs and preferences.

Orthodontists are also used to obsessing over differences of less than 0.5 mm. When a meticulous orthodontist’s aesthetic sense meets a highly skilled dental laboratory, the result can be excellent. For this reason, I think it is best when the orthodontist handles the laminates as well after finishing orthodontic treatment.

Today, I will show you the 6-month treatment process of a patient in their 60s who came in for no-prep laminates.

This is a patient in their 60s who came in for no-prep laminates.

Because of an edge-to-edge bite, where the upper and lower teeth meet at their edges, the edges of the upper teeth are worn and chipped in many places. If a malocclusion such as an edge-to-edge bite is left untreated for a long time, teeth are more likely to chip due to the impact of chewing.

In a case like this edge-to-edge bite, no-prep laminates cannot be done. They can be done, but they will almost certainly break, or the lower teeth will hit the laminates first and wear them down. If the area that contacts the lower teeth is reduced, this problem would not occur, but the patient came specifically for no-prep laminates because they did not want tooth reduction, so that would not be possible.

After sufficiently explaining that only when the upper teeth properly cover the lower teeth in a normal bite can laminates be maintained healthily and for a long time without reduction, without damage to the lower teeth, and without laminate fracture, we recommended partial orthodontic treatment of the front teeth. Partial orthodontic treatment of the front teeth is orthodontics that finishes within 6 months at most, but for older patients, even this can be quite uncomfortable. Fortunately, the molar alignment and bite were very good, so only partial orthodontic treatment of the front teeth was needed.

Therefore, we attached appliances only to the front teeth and decided to resolve the edge-to-edge bite through a minimal 5-month short-term orthodontic treatment to create an environment suitable for no-prep laminates and to align the crooked lower front teeth neatly. We attached Clippy C appliances to the 6 upper teeth from canine to canine and 2D appliances to the 6 lower front teeth, then carried out front-teeth orthodontic treatment for 5 months.

23.02~23.07

The edge-to-edge bite was corrected, and the upper teeth came to cover the lower teeth.

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The lower front teeth were also aligned neatly.

Since we created a good environment through orthodontics, we prepared for no-prep laminates. Through fitting, it is necessary to communicate sufficiently about lip discomfort due to the thickness of the laminates, lip volume, tooth length, and color. Because the back molars are also visible when smiling, we decided to do a total of 8 upper no-prep laminates, extending to the small molars behind the canines.

No-prep laminate fitting

No-prep laminate fitting

While fitting, we shortened the length as the patient wanted. We also decided to make the color one shade darker than during fitting in order to reduce the difference from the lower teeth.

If we had not done the fitting, the laminates would likely have been completed without considering these points, and the patient may not have liked them.

Just leave it to the doctor and make it pretty

can be risky. The doctor’s aesthetic perspective and the patient’s perspective can be different.

Immediately after orthodontics - no-prep laminates completed 23.07~23.08

From fitting to the final no-prep laminates, the total time required was 3 weeks. From the end of orthodontic treatment to the fitting appointment took 10 days, and from fitting to laminate fabrication took another 10 days.

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This is the appearance before orthodontics, after orthodontics, and after completing the no-prep laminates.

The total treatment time was 6 months.

Once the edge-to-edge bite was corrected, the no-prep laminates fit beautifully without contacting the lower teeth first or requiring any reduction. Because the bite was established so that the upper teeth appropriately cover the lower teeth from the front, the laminates will not be supported by the lower teeth and break.

Not only did the no-prep laminates make the teeth look cleaner and brighter, but because of the partial orthodontic treatment that moved the front teeth forward and the thickness of the no-prep laminates, the volume in the upper lip and philtrum area was restored, making the patient look much younger. As people age, the skin becomes thinner and lip support decreases, making the philtrum and lip area look sunken, but even without plastic surgery, partial orthodontic treatment of the front teeth and no-prep laminates alone can compensate for the volume in this area.

23.0223.0723.08

23.02~23.08

In an era where people live to 100, being in your 60s means you are just turning the corner in life. Don’t think it is too late.

Thank you for reading this long post today.