Bimaxillary protrusion. Spacing of upper front teeth
Dear Dr. Chamberland, I have bimaxilliary protrusion with spaces between my upper front teeth and no spaces in my bottom teeth. I have six crowns in my upper jaw and the dentist says they may not hold braces. My smile is gummy and my upper teeth are large. Which treatment would you recommend to close the spaces and reduce protrusion? I have images that I would like to send you both scans and photograph that would give you better insight.
It is possible to bond brackets to porcelain crown. A special etch technique (porcelain etch and porcelain surface conditioner, rely-a-bond primer and paste from Reliance co.) is necessary, but it work fine and it will hold during your treatment.
See these exemple:
If the crown are on your front upper teeth, they may need to be redone after the orthodontic treatment.
Generally speaking, bimax protrusion requires 4 dental unit extraction, although this can be reassess after closer upper spaces. Keep in mind that if you have deep bite, it will need to be address before retraction of the upper teeth. Gummy smile often need orthognathic surgery (Le Fort 1 superior repositioning along with mandibular surgical accommodation.)
I hope that help.