Hi there,
In August 2023 I noticed that one of my central incisors was a little higher, by a millimeter or so. After tracking my photos since mid-2019, when the second braces were removed, I found that I had had the tooth like that since the beginning of 2022 and I had not noticed it.
Picture after the orthodontics treatment:
Picture from February 2022
As I had a consultation with my periodontist for gum recession control, I told him what was happening and showed him that the tooth with the retainer in place looked shorter. The periodontist told me that it looked like tooth wear to him and that he would not do anything because it was practically imperceptible.
Just in August, I also had resin replaced on my other central incisor.
When I was a little girl, about eleven years old, I was hit in the teeth by a racket in a tennis lesson. The left central incisor broke off a little bit and the right central incisor had a dead nerve, so it had to be root canalized. A traumatic experience.
After the resin was changed, although it was a small piece of less than a millimeter, the upper retainer began to tighten.
As there seemed to be no one in Porto capable of making a retainer and even less for a normal price, I decided to go to Valencia with my orthodontist so that she could also see the tooth that had come up. She saw the orthopantomography of February 2023 and told me that it seemed to her that the tooth had ankylosis and that is why it had come up.
This was horrible news because an ankylosed tooth will never be able to move again, it functions like an implant. Besides, I could end up losing it in a few years.
I had to take other x-rays to confirm if it was ankylosis and if it was that the only option was to reconstruct the tooth with stratified composite.
The best in Spain is Javier Cremades in Madrid. My orthodontist agreed to call him to see if he knew anyone as good as him in Porto.
He then recommended Carlos Falcão. I wrote him on Instagram since I saw that he spoke Spanish and told him about my case.
I made the appointment for October 10.
I had a new orthopantomography and he told me that he did not think the tooth had ankylosis. He did another x-ray of the tooth alone and a CAT scan of the mouth and completely ruled out ankylosis.
This was good news and meant that I could move the tooth naturally again with orthodontics if I preferred. In any case, even if I had orthodontics, the tooth needed some reconstruction on the bottom because it lacked volume.
The only problem he saw with doing the reconstruction was that the edge of the gum would always be higher than the left central incisor. That was not a big problem for me because when I smile, I don’t show the gum line.
He told me that it was also true that a tooth with a root canal was better to leave it alone, so perhaps it was better not to move it again.
If I had the reconstruction done, they would do the retainer themselves.
He gave me an estimate: 250 euros for the reconstruction and 30 euros for the retainer.
Diego and I could not believe the price of the retainer after the atrocities of prices we had seen in Porto.
This, against the 3000 euros that it would cost to put me back in orthodontics and perhaps a year of treatment.
My orthodontist told me that she did not know if it was worth it to put me back in orthodontics and that the tooth could move again in the future.
I decided to go ahead with the reconstruction because it was the quickest solution and it did not damage the tooth (as would with a veneer); in addition, if I wanted to get an orthodontic treatment in the future, I could do so without any problems.
On October 18 I had the appointment for the reconstruction and on October 31 I would return to have the tooth polished, which was essential for the reconstruction to last longer.
It was hard to get to what I felt was right looking in the mirror. Depending on how I stood or what angle I looked from, I would see it shorter or longer. Since my smile and jaw are not straight, it was difficult for me to know the perfect height. Also, because the reconstructed tooth was so perfect, I also saw it as odd in relation to the other one. Especially because my central incisors have different shapes, one more straight and the other more triangular.
But in general, I was very happy with the result.
Even so, I had to go back because the retainer was too tight, and Dr. asked me how I felt. I told him that the only thing that bothered me visually was that the reconstructed tooth was straight down, and all my teeth were rounded at the bottom, and I asked him if it was possible to modify it. We made a new appointment.
He left it a little more rounded at the bottom and I liked that result better. Although I still would have perfected it on one of the corners. Since I already had the retainer made and I was going on a month-long trip, I decided not to modify the tooth any further.
As you saw in another post, getting a retainer in Porto seemed to be mission impossible. After the reconstruction of the tooth, I had the retainer made and it was quite tight, the doctor told me that it was too stiff and that I would have another one made. They took the mold for the second retainer and when I went to get it, it had turned out to be terrible because the incisors did not fit completely, and a molar was loose without retention.
We repeated the mold twice more because the first one came out wrong. I was very anxious because I was about to go on a trip, and I didn’t know if they were going to be able to make the retainer. I was terrified because if the third attempt went wrong, I didn’t know what I was going to do to find a place where I could get the retainer done right.
I went to get the third retainer and it was perfect, I took 20 years of pure tension and stress off my shoulders.
When I returned from the trip to Durham, I went to have my tooth touched up a third time because it was still too short. I had the mold made again for the new retainer and when I went to get it the next day, it was wrong again. The incisors didn’t even fit in the retainer and the dental assistant came out to tell me that it was perfect like that. I could not believe it.
Since I had an appointment the following Tuesday with the orthodontist, I told them to have the doctor take the mold and see if they could finally make it right. I spent a week putting in the old retainer, which still fit better than the new one they had made for me.
I was so anxious I decided to go to my orthodontist in Valencia so I could take advantage of the opportunity to have both retainers made and the teeth cleaned. I cancelled the appointment with the orthodontist at the Porto Medical Institute and there I would simply go for the reconstruction check-up and nothing else.
As I would probably have braces in the future to lower the tooth naturally, I preferred to do it with my orthodontist in Valencia who is extremely professional and where they would be able to make me a retainer without problems.
It is important to keep in mind when reconstructing with layered composite:
- It does not damage the tooth and you can always go back to how the tooth was before the reconstruction. That is why I recommend it before placing veneers.
- You must follow up and go for a consultation every 6 months.
- The reconstruction lasts between 5 and 10 years depending on the care that the patient takes.
- Beyond the fact that it could break, which was what the doctor gave less importance to, what could happen is that the reconstructed piece could become stained if the person smokes or consumes beverages such as soft drinks and red wine.
- The doctor told me that you can lead a normal life and even bite hard things with your front teeth.
Prices:
Evaluation appointment: 80 euros
Reconstruction: 250 euros
Retainer: 30 euros