Enameloplasty, also called odontoplasty, dental contouring, tooth reshaping, or tooth stripping, is a cosmetic dentistry procedure in which a very small amount of enamel is removed or filed to change the length, shape, or surface of a tooth. (2)
When is Odontoplasty Used?
Odontoplasty is an excellent cosmetic procedure that can fix minor dental imperfections in a comfortable and painless way. It can be used for:
Correcting the appearance of chipped teeth
Smoothing out the sharp edges of teeth
Shortening teeth that appear longer than usual
Reshaping canines into laterals in case of missing laterals
Minor adjustments in the bite
Gaining space to fix teeth alignment through orthodontic treatment IPR
Adjunct to fissure sealants application in deep fissures (Better retention and less microleakage (1)
Enameloplasty in clear aligner treatments
IPR (or interproximal reduction) is a form of enameloplasty, and is an essential step in most clear aligner treatments. It helps to create space in the arch so the teeth can move into their correct positions. (3)
In several cases, tooth contouring is performed as a finishing procedure after clear aligners. While clear aligners bring the teeth to their proper alignment, the dimensions of the teeth may not be in proportion.
Dental contouring can then transform your patient’s smile into a perfect one! Through tooth reshaping, the minor alterations in the length of the teeth can be adjusted, and any existing unaesthetic spaces between the teeth can be closed. (2)
Who Are Enameloplasty Candidates?
Just like any other dental procedure, dental contouring is not applicable in every case. An ideal candidate for enameloplasty would have:
Teeth with uneven edges: Individuals with teeth that are slightly chipped off or are not in the correct shape can be recommended enameloplasty.
Pointed or unusually long teeth: In the case of long or pointed teeth, enameloplasty can be done to reshape them to their ideal form and create an even smile.
Clear aligners or braces treatment: Interproximal reduction or IPR is a form of enameloplasty in which the proximal teeth surfaces are trimmed minimally to reduce the width of the teeth and break tight contacts. The space gained through IPR is utilized for the desired orthodontic teeth movement with clear aligners or braces.
Teeth with deep pits and fissures: Deep pits and fissures are found in newly erupted teeth quite often. They serve as excellent breeding spots for food accumulation and decay-causing bacteria. Enameloplasty can transform the deep inaccessible pits and fissures to smooth areas where the toothbrush bristles can easily reach and clean food debris.
Following enameloplasty, the application of pit and fissure sealants can be done to prevent decay from occurring. It has been observed that enameloplasty done before the application of sealants can prevent microleakage, ensure better retention of the sealant, and hence better protection against dental caries. (1)
Missing lateral incisors: A canine tooth right next to a central incisor may not result in an esthetic smile. Hence, cosmetic dentists prefer reshaping the canines into laterals through enameloplasty.
How Do You Do An Odontoplasty?
Below we’ve outlined the teeth reshaping procedure step by step:
1. Tooth trimming:
The teeth that need to be contoured are first identified, after which, the dentist trims the enamel to achieve the desired shape. As the enamel is devoid of nerves, the procedure is absolutely painless. However, patients who anticipate discomfort can be given local anesthesia.
2. Instruments use:
If the proximal sides of the teeth are to be reduced, abrasive strips and discs attached to slow-speed handpieces can be used. In addition, conventional burs (drills) can be used to reduce the incisal/occlusal edges. 8) Lastly, specialized lasers for dental recontouring can also help give a good finish. (7)
3. Tooth polishing:
After recontouring, the teeth are polished to achieve a glossy finish. The primary focus here is to create smooth tooth surfaces, as rough areas attract plaque accumulation and lead to dental decay.
5. Benefits of Enameloplasty
The benefits of enameloplasty or tooth recontouring are many:
Conservative: One of the most minimally invasive procedures in cosmetic dentistry.
Painless: As nerves are not present in the enamel layer, patients generally do not experience much pain or discomfort during this procedure.
No need for recovery: Individuals can eat or drink as usual and resume their daily activities soon after the procedure.
Protection from oral issues like decay: Areas on the teeth with a high chance of plaque accumulation (like deep pits and grooves) can be recontoured to protect the teeth from bacterial attack and prevent dental decay.
Improved self-esteem: A pleasant smile works wonders for one’s self-esteem and boosts self-confidence.
Not time-consuming: As the procedure is quite quick, it can be completed within a single session itself.
6. Alternatives to enameloplasty
While enameloplasty is a quick and inexpensive option, it may not be an ideal treatment option in every case. One can consider alternatives such as
Composite fillings: In this technique, the composite resin is used to build up deformities like chipped or cracked portions of the teeth.
Crowns or bridges: If the teeth have deep caries, then crowns are considered ideal for restoring the lost tooth structure.
Veneers: Both composite or porcelain veneers can be used to make cosmetic adjustments on the teeth. They work well for teeth with defects like discolorations or shape irregularities but come at a much higher cost than composite bonding or crowns.
Recovery & Follow-Up
There is no need for a recovery period as one is fit to resume his normal activities soon after enameloplasty. The procedure will not exceed more than a single session. Fluoride varnish can be applied after the session, and the patient can be advised to use fluoridated mouthwash and toothpaste along with their regular oral hygiene routine.
Enameloplasty is an excellent procedure to help fix minor issues related to the shape, form, or alignment of teeth. It can be done on chipped, pointed, or slightly misshapen teeth. It helps in preventing dental decay and enhances the efficiency of pit and fissure sealants. It may not be an ideal treatment option in every case. A thorough clinical evaluation can help determine whether enameloplasty can resolve dental issues in your patient.
FAQs (for doctors)
How much enameloplasty can be done in 'mm'?
Studies reveal that only 50% of the enamel on the sides of the teeth can be removed without posing any threat to the teeth or adjacent gums. (5)
What is the enameloplasty ADA Code?
The enameloplasty ADA code is D9971. It stands for a dental procedure that involves the removal of tooth structure without replacement. (9)
FAQs (for patients)
What is Odontoplasty on a tooth?
Odontoplasty is a minimally invasive, safe, and comfortable cosmetic procedure in which a very small amount of enamel is removed to achieve an ideal look or shape of your teeth. (2)
Is enameloplasty harmful?
No. Enameloplasty or tooth shaving is performed only on the outermost layer of enamel, and only a very thin layer is removed, so there is negligible risk involved.
How fast can a dentist make my teeth beautiful by reshaping?
Dental recontouring is a single-appointment procedure in most cases. If cleared for the procedure, you will be able to walk out with a beautiful even smile in just a couple of hours!
How long does enameloplasty last?
As enameloplasty involves the removal of a very small amount of enamel, the procedure may not need more than half an hour. The total duration, although, depends on the number of teeth that need to be reshaped.
Does enameloplasty hurt?
No. As nerves are not present in the enamel layer, enameloplasty is not a painful procedure. (10)
Odontoplasty vs. enameloplasty
Odontoplasty is another name for enameloplasty. It is also known as dental contouring, tooth reshaping, or tooth stripping.
Soleymani, A., Bahrololoomi, Z., Javadinejadi, S. and Salehi, P. (2014). Evaluation of the Effects of Enameloplasty and Air Abrasion on Sealant Micro-Leakage. Journal of Dentistry (Tehran, Iran), [online] 11(6). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281185/ [Accessed 26 Oct. 2022].
Huang, A.T. and Huang, D. (2022). Interproximal Reduction. Controversies in Clear Aligner Therapy, pp.89–100. doi:10.1007/978-3-030-92810-0_5.
Carlos Pontons-Melo, J., Garcia, I., Vargas, M., Fabrício and Collares, M. (2020). Bio-additive and enameloplasty technique for restoring anterior esthetics: 54-month clinical follow-up. QUINTESSENCE INTERNATIONAL |, [online] 51(8). doi:10.3290/j.qi.a44814).
Laganà, G., Malara, A., Lione, R., Danesi, C., Meuli, S., & Cozza, P. (2021). Enamel interproximal reduction during treatment with clear aligners: digital planning versus OrthoCAD analysis. BMC oral health, 21(1), 199. https://doi.org/10.1186/s12903-021-01487-2
da Cruz MK, Martos J, Silveira LF, Duarte PM, Neto JB. Odontoplasty associated with clinical crown lengthening in management of extensive crown destruction. J Conserv Dent. 2012;15(1):56-60. doi:10.4103/0972-0707.92608
Pontons-Melo, J.C., Atzeri, G., Collares, F.M. and Hirata, R. (2019). Cosmetic recontouring for achieving anterior esthetics. The International Journal of Esthetic Dentistry, [online] 14(2), pp.134–146. Available at: https://pubmed.ncbi.nlm.nih.gov/31061994/ [Accessed 2 Nov. 2022].