Managing Congenitally Missing Lateral Incisors. Part I: Canine Substitution

Abstract

Patients with congenitally missing lateral incisors often raise difficult treatment planning issues. Therefore, to produce the most predictable esthetic results, it is important to choose the treatment that will best address the initial diagnosis. This article is the first in a three-part series that describes the different treatments available for patients with congenitally missing lateral incisors. This first article focuses on canine substitution as a method of tooth replacement for these missing teeth. The general dentist will learn to evaluate specific patient selection criteria and determine whether canine substitution is an appropriate treatment alternative for replacing missing lateral incisors. The orthodontist will understand how to position the canines to satisfy functional requirements and achieve proper esthetics. Finally, the importance of interdisciplinary team treatment planning is emphasized as a requirement for achieving optimal final esthetics.

Communication practices and preferences between orthodontists and general dentists

“…3 The dentist likely wants to understand the orthodontic treatment objectives and plan, especially if the patient requires extractions, the restoration of a malformed tooth, or the replacement of a missing tooth. Despite some attempts to systematically determine which teeth should be extracted during extraction therapy 5,6 and the widespread understanding of the available treatment options to restore or replace deformed or missing teeth, [7][8][9][10][11][12] it is important that both the orthodontist and general dentist agree on the ultimate treatment goal so each provider can facilitate its attainment.…”

Konjenital Diş Eksikliklerinde Tedavi Seçenekleri

“…Generally, a flat profile is regarded as ideal. A slightly con--vex profile is also acceptable (26).…”

“…For acceptable aesthetics and normal occlusion, a significant amount of me--siodistal reduction is required. As a result of significant amount of enamel removal, un--derlying dentine layer is reflected and a loss of aesthetics occurs (26).…”

A Three-Dimensional FEA of Implants to Investigate Effects of Angle Implantation Cases in Implants Success

“…1) these include removable dental prostheses, conventional fixed dental prostheses (fdps), resinbonded fdps, orthodontic repositioning of canines to close the edentulous space, and single-tooth implant deboning rates of 25-31% have been reported for these restorations [8], [9]. 2) in cases where the occlusion and esthetics of the canine in the lateral position are acceptable, closure of the lateral space by the mesially positioned canine, which may be the simplest alternative treatment option [8], [10]. 3) implants placed at positions off the vertical axis have been referred to as "tilted implants" or "off-axis fixtures."…”