We often come across a missing anterior tooth or have a space emerge during orthodontic treatment. To avoid the resulting poor social smile during treatment, we can provide the patient with a temporary phantom tooth made of regular non flowable composite used in the office. The main advantage of using a temporary phantom tooth is a boost to the patient’s confidence.
The fact is: Poor self-confidence may lead to discontinuation of orthodontic treatment and/or the patient seeking treatment alternatives. A phantom tooth has the advantage of satisfying an aesthetic need and providing a temporary space maintainer (Figure 1)—a win-win situation for the patient and the orthodontist.
A retainer strip of “dead-soft” wire is used—6 inches of 010″ x .028″ wire. This can be easily formed; and its flat dimensions are ideal for retaining final torque positions (Figure 2). A retainer with adequate length is formed by bending the two ends. This will depend on the inclination of the teeth adjacent to the missing tooth. The retainer is secured on to the lingual side. Incremental composite (Tetric N-Ceram from Ivoclar Vivadent) buildup is then cured to the lingual retainer (Figure 3) to match the shade of the patient’s teeth.
The finishing is completed with a composite finishing bur for an artistic finish and a formed retainer strip used to hold the built tooth structure without major displacement.
The phantom tooth technique is not cumbersome. Incremental addition of composite and trimming may be done to manipulate the size of the temporary phantom tooth according to the case. This is an easy way of maintaining the space and aesthetics (Figure 4) until the patient is ready for a permanent fixed prosthetic denture or an implant. OP
Venkat Ambekar, MDS; Anirudh K. Mathur, MDS; Balan K. Thushar, orthodontic resident, AV’s Happydent Dental & Orthodontic Care, Hyderabad, India.