[Central incisor and individualizing treatment of the smile due to orthodontics]

The objectives of the orthodontic treatment that we provide are to re-establish functional occlusion and a harmonious facial appearance, taking the individual anatomic features of each patient into account as well the potential changes that will come with ageing. As a pre-treatment first step we analyze the position of the incisor teeth within the face. Next we pose several questions. Should we preserve a slight bi-maxillary protrusion or correct it? Should we decide to voluntarily maintain a slight supraclusion? When should we correct a gummy smile? What should we do about black holes? In this article we propose treatment approaches, illustrating them with clinical situations and focus on the critical role played by the central incisor in establishing smiles that are suitable for each patient, integrating them with the ageing patterns that we know the future will bring.