Premolar substitution

- This is when the canines are missing and we choose to move the premolars into the canine position
- Depending on the smile line, an implant in the canine area may develop an unattractive gum margin, sometimes years later
- The premolar is then intruded to create a canine-like higher gum contour
- The crown of the premolar is reshaped to resemble a canine by reducing the inside cusp
- The more visible outside cusp is built up with composite to resemble a canine
- The dentist may later recommend a crown or a veneer on the premolar to make a more perfect canine shape
- If this is done an implant is placed in the premolar area