Anterior teeth vary in shape, including crown height, width, and gingival-incisal edge contour. It is a common procedure for an orthodontist to reshape incisal edges of the maxillary incisors to obtain better esthetic anterior dental contours. Some clinicians recommend reshaping the incisal edges before bracket placement to better visualize the crown in ideal proportion before bracket placement. Others reshape the incisal edges in the finishing stage for refinement of the orthodontic outcome. By incorporating cosmetic dental thinking, it is not unreasonable for orthodontists to also consider tooth shape and proportionality, and gingival contouring,1,2 as part of treatment planning and goal setting. But there is little evidence-based information available on tooth reshaping. What knowledge do we have when it comes to questions like how much enamel can safely be removed from maxillary and mandibular anterior teeth in adolescents and adults, and what is the preferred technique and the limitations for performing such recontouring?
David M. Sarver, Vestavia Hills, Alabama, USA