Essay III: Adhesive restorative options for restorative space management in the anterior zone with or without orthodontic pretreatment: some clinical considerations and case presentations.

An unfavorable relationship between the form and dimension of the dental arch and the number, dimension, and shape of the existing teeth can pose several esthetic, biologic, and functional problems. In this article, the various restorative options are discussed based on clinical and scientific evidence: Gap closure and substitution of missing teeth: restorative transformation of substituted teeth into homologous teeth with odontoplasty, direct composite, etched pieces or porcelain veneers. Gap opening and tooth replacement with all-ceramic adhesive bridges, including pontic site development. Gap distribution and restorative compensation with direct composite restorations, etched pieces or porcelain veneers. Gap shifting and restorative compensation with all-ceramic adhesive bridges, composite, etched pieces or veneers. Gap compensation by reconstructive compensation without orthodontics. The reconstructive tools including composite restorations, ceramic veneers, and adhesive bridges are discussed, and numerous cases are presented to illustrate the concepts.