Orthodontic Space Closure of a Missing Maxillary Lateral Incisor Followed by Canine Lateralization

Abstract

Maxillary lateral incisor agenesis is the most prevalent developmental dental anomaly. The management of missing lateral incisor was either closure using canine as substitution or creation of space orthodontically for prosthetic replacement. A careful diagnosis and treatment plan are deemed essential to address the patient’s needs as the spacing is present in the esthetic region. Such problem is very challenging for orthodontists, prosthodontists, and general practitioners. This case report describes the orthodontic management of a 22-year-old adult female patient with missing upper left lateral incisor tooth and upper anterior spacing by closing the space with canine lateralization and reshaping to simulate it with the lateral incisor. However, some modifications in the treatment mechanics are crucial to achieve the optimal esthetic and to improve the occlusion. Space closure with canine lateralization option seems less invasive, treatment can be completed relatively in a short period of time, and its adaptation with the facial changes throughout life without having artificial prosthesis provided other factors favoring for this option.

Maxillary Impacted Canine and Upper Lateral Incisor Agenesis Treatment with “Canine First Technique” and Clear Aligners: A Case Report

“…The aim of this study is to present a case of an impacted maxillary canine and agenesis of an upper lateral incisor that was treated with a combined hybrid approach. Due to its location in the aesthetic region, unilateral agenesis of the maxillary lateral incisor may have affected the patient’s quality of life [ 11 ]. In these cases, the decision of whether to open or close the space should be individualized for each patient.…”

“…One of the most common developmental anomalies is the absence of the maxillary lateral incisor (agenesis) [ 5 ]. In general, either the closure of the space, often with canine replacement, or the opening of the space for subsequent prosthetic restoration are the most widely used options to treat patients with congenitally missing maxillary lateral incisors [ 11 , 12 ]. Closing the missing lateral incisor space by lateralization of the canine and reshaping it to resemble the lateral incisor is preferable when comparing the above treatment options.…”

“…Several factors should be taken into account when designing a treatment plan to decide between these two options. These factors include the canine size, shape, and colour, location, patient age, patient profile, smile line, arch length tooth size discrepancy, ridge thickness, existing occlusion, and patient expectations of treatment [ 11 ]. Furthermore, to determine the level of commitment and motivation, the clinician should assess the patient’s psychological and behavioural profile [ 14 ].…”

Prevalence of Clinically Missing Permanent Teeth Due to Agenesis and Secondary Factors among Patients between 8-17 Age Group Visiting a Private Dental Hospital - an Institutional Study

“…2]. As mentioned earlier, certain syndromes like ectodermal dysplasia, cleft lip and palate have led to congenital defect of lateral incisors [26].…”