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Tooth reshaping as an integral part of orthodontic treatment

From Volume 7, Issue 4, October 2014 | Pages 118-120


Sarah E Griffiths


Senior House Officer in Oral and Maxillofacial Surgery, Royal Hallamshire Hospital, Glossop Road, Sheffield, South Yorkshire S10 2JF

Articles by Sarah E Griffiths

P Jonathan Sandler

BDS(Hons), MSc, FDS RCPS, MOrth, RCS

Consultant Orthodontist, Chesterfield Royal Hospital, Chesterfield

Articles by P Jonathan Sandler


Tooth reshaping is becoming an integral part of orthodontic treatment to maximize the aesthetic outcome. The removal of incisor mamelons with Sof-Lex™ discs is a straightforward, easy and minimally invasive way of dramatically improving the appearance of previously unworn incisors. This method can be used during the finishing stages of orthodontic treatment.

Clinical Relevance: The dental team often encounters patients with misshapen and malformed teeth. Reshaping teeth is fast becoming an integral part of orthodontic treatment. When used in appropriate cases, tooth reshaping can be an effective, minimally invasive technique to achieve a highly aesthetic result


Teeth may be reshaped for various reasons as a part of orthodontic treatment. Common examples of tooth reduction include removal of mamelons where lack of tooth contact has prevented significant abrasion and recontouring fractured, uneven incisal edges. Following trauma, central incisors may end up with an unfavourable width-to-length ratio, and this was discussed in a case involving ankylosed central incisors following avulsion and re-implantation.1 Other examples where teeth need reshaping include patients with congenitally missing lateral incisors where treatment results in canine substitution for the laterals.2 Tooth reshaping may also be required as mesial and distal enamel reduction (interdental stripping) as an alternative to the extraction of permanent units. It is a popular method for gaining space which allows alignment of irregularly positioned teeth.3,4

Excluding third molars, maxillary lateral incisors are the most commonly congenitally missing teeth with a reported incidence of 2%.5 When patients present with missing lateral incisors, historically the space was often opened up for placement of adhesive bridges or single-toothed implants. Recently, with the improvement of bleaching techniques, canine substitution increasingly forms part of the treatment plan. Contouring the canine appropriately and ensuring that the canine cusps are sympathetically reduced can give the illusion that they are lateral incisors.2

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