Maxillary Lateral Incisor Agenesis: Making the Correct Decision

Lateral incisor agenesis has long been a clinical dilemma. Do we treat it with space opening and implant placement or orthodontic space closing? This presentation will help clinicians make the correct decision with special focus on the long term prognosis of the space opening option. How do we maintain the space until the implant is placed? How can we avoid bone loss in the area? Once the implant is placed, why is progressive infraocclusion observed? How can we avoid it? All this and more will be answered.

Tooth agenesis represents one of the most frequent developmental anomalies in the human dentition. Approximately 1 in 50 children presents with clinically missing maxillary lateral incisors. Following diagnosis, the optimal treatment in these cases remains subject to controversy, both in the literature and in clinical reality. This demonstrates the importance of multidisciplinary analysis of these patients with orthodontists collaborating with periodontists and prosthodontists. Two treatment options are possible: Orthodontic space closure and space opening. The later necessitates the placement of dental implants in the esthetic zone which in turn presents many disadvantages among which is progressive infraocclusion. This phenomenon has been well documented in history with patients even after the completion of growth. The goal of this presentation is highlight the importance pf residual vertical growth in the maxilla and how it may sway the treatment need for patients with maxillary lateral agenesis. Moreover, a new orthodontic microimplant aided solution for a long term transitional restoration will be presented.

Learning objectives :

• Highlight advantages and disadvantages of orthodontic space opening and space closing.
• Present all possible long term transitional restorations for space opening cases and their effects on the vertical growth of the maxilla.
• Present a new orthodontic microimplant aided solution for a long term transitional restoration.