The evaluation with respect to the augmentation material used did not reveal significant differences in the implant survival rate and in both cases remodelling processes could be observed in the augmented area.
Ageneses exhibit a prevalence of 5.5% and are thus one of the most common congenital anomalies encountered in humans. The incidence of aplasia is often only diagnosed coincidentally in the mixed dentition unless accompanied by additional syndromal ectodermal anomalies phenotypical with the aplasia. In cases of solitary agenesis, it is frequently the second tooth of a group which is affected. Treatment planning and initiation should be carried out at an early stage and interdisciplinary whereby asymmetrical and multiple ageneses are highly complex and involve prosthetic restoration, jaw relationship, functioning and aesthetics. The treatment options for solitary and symmetrical ageneses appear considerably more straight forward and variable.
15 years ago, an interdisciplinary concept, covering the controversial topic of implants in growing patients, was developed which aimed at producing early positive functional and aesthetic results in the upper anterior region of adolescents. Following anterior tooth trauma and in cases of agenesis, extensive orthodontic diagnostic and therapeutic pretreatment was first performed according to modifications of the accepted guidelines for adults followed by implant placement anticipating expected jaw growth. The objective is to prevent inactivity atrophy following tooth loss and achieve symmetry to the contralateral tooth once growth has been concluded. The concept encompasses modifications to the prosthetic restoration. 179 implants were placed in the upper anterior regions of patients aged between 12 and 17 years. The results obtained during the growth period were checked every six months and evaluated using standardised photo documentation. To date, the examinations up to conclusion of growth have been carried out, evaluated and published for 67 implants.The outcome of the photometric analysis indicates that, in comparison to the corresponding teeth during the growth period, compromises in the aesthetics of the emergence profile must be accepted but that, in all cases, once jaw growth has been concluded, the white and pink aesthetics exhibit no significant differences to the corresponding teeth.
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