Analysis of width/height ratio and gingival zenith in patients with bilateral agenesis of maxillary lateral incisor

Abstract

OBJECTIVE: The purpose of this study was to evaluate the width/length ratio and the gingival zenith (GZ), by means of dental casts and digital caliper, in patients with missing maxillary lateral incisors after treatment. METHODS: The sample was composed of 52 subjects divided into 3 groups: BRG (n = 18), patients with bilateral agenesis treated with tooth re-contouring; BIG (n = 10) patients with agenesis treated with implants and CG (n = 24), control group. The data were analyzed using Shapiro-Wilk, Spearman correlation, Wilcoxon, Kruskal-Wallis, t test and ANOVA tests (p < 0.05). RESULTS: For the width/length ratio of the lateral incisors, BIG presented the lowest mean values (0.72 right and left), when compared with other groups. However, comparison between groups presented statistically significant differences for the right lateral incisor (BIG x CG) and for the canine (BRG x CG). GZ data evaluation showed the greatest difference for BRG (0.5 right and 0.48 left). BIG (0.95 right and 0.98 left) and CG (0.98 right and 0.8 left) presented more similar values, nevertheless, without statistical difference (p > 0.05). GZ data for the right and left sides of the smile were not considered statistically different. CONCLUSION: Although no statistical difference was found in the comparison between the groups, analysis of the descriptive values showed that group BIG showed the greatest difference in values with regard to width/length ratio. Regarding gingival zenith, BRG showed the greatest difference.<br>OBJETIVO: o propósito desse estudo foi analisar, por meio de modelos de estudo e paquímetro digital, a proporção largura/altura e o zênite gengival (ZG) em pacientes com agenesia bilateral do incisivo lateral superior após o tratamento. MÉTODOS: a amostra consistiu de 52 voluntários divididos em 3 grupos: GBR (n=18), pacientes com agenesia bilateral tratados com reanatomizações dentárias; GBI (n=10), pacientes com agenesia bilateral tratados com implantes; e GC (n=24), grupo controle. Os dados foram avaliados por meio dos testes de Shapiro-Wilk, Wilcoxon, Kruskal-Wallis, teste t, ANOVA (p<0,05) e correlação de Spearman. RESULTADOS: para a proporção largura/altura dos incisivos laterais, o GBI apresentou menores valores (0,72 direito e esquerdo), quando comparado aos demais. Porém, a comparação intergrupos revelou diferenças estatisticamente significativas para o incisivo lateral direito (GBI x GC) e para o canino (GBR x GC). A avaliação das medianas obtidas para o ZG demonstrou que o GBR foi o mais destoante (0,5 direito e 0,48 esquerdo), e que o GBI (0,95 direito e 0,98 esquerdo) e o GC (0,98 direito e 0,8 esquerdo) apresentaram valores semelhantes, sem diferença estatisticamente significativa (p>0,05). Os valores obtidos para os lados direito e esquerdo foram considerados iguais dentro de cada grupo. CONCLUSÃO: embora não tenham sido encontradas diferenças estatísticas na comparação entre os grupos, pela análise descritiva dos dados, o GBI foi o grupo que apresentou as medidas mais destoantes dos demais em relação à ...

Authors’ response

“…The aim was to repeat the study of Armbruster et al 2 from 2005, in which "all 12 cases were photographed after the completion of orthodontic treatment and any restorative dental work," and not after years in retention, to evaluate whether the introduction of new techniques in implantology and periodontics over the last 10 years has improved the esthetic appeal of implant-borne crowns for congenitally missing maxillary lateral incisors, as suggested by various research groups. [3][4][5] Our study clearly shows that the esthetic outcomes in the short term are rated significantly better than 10 years ago-nothing more and nothing less. It was not our intention to interpolate long-term esthetics or functional stability of single-tooth implants in the anterior maxilla from the study, for which sound scientific evidence is currently not available.…”

Congenitally Missing Maxillary Lateral Incisors: Update on the Functional and Esthetic Parameters of Patients Treated with Implants or Space Closure and Teeth Recontouring

“…In addition to recontouring, it is necessary to orthodontically extrude the maxillary canine and intrude the premolar in order to establish the naturally appearing high-low-high marginal gingival contours of the maxillary anterior teeth [ 44 ]. However, some studies have shown that reestablishing the gingival zenith agreeing with the pattern proposed in the literature may not always be possible [ 27 , 40 , 43 ].…”

“…Moreover, recent studies [ 40 , 43 ] have also shown that patients treated with canine recontouring presented the zeniths of the replaced lateral incisors predominantly coincident or above the reference line from the zenith of central incisors to canines (Fig. 1 ).…”

“…Concerning the gingival architecture and the composition of the gingival zenith, the treatment of patients with MLIA with implants showed better results when compared with patients treated with space closure and canine recontouring (Fig. 2 ) [ 40 , 43 ]. However, progressive infraocclusion in the implant area can occur after some years because of the continuous eruption of adjacent teeth, even in adults and elderly patients [ 44 ].…”

Comparison of Esthetic Outcomes of Maxillary Lateral Incisor Agenesis Treatment by Orthodontic Space Closure Versus Implant Placement (Evaluated by Pink Esthetic Score)

“…Further, the first premolar tooth should change into canine tooth. Since these teeth are different in terms of anatomy, color, and gum height, if the tooth replacement is not performed well, the static results of the treatment will be impaired (Rosa, 2007;Pini, 2012). If this process is well planned and performed based on an interdisciplinary approach, acceptable outcomes can be achieved (Krassnig, 2011;Zachrisson, 2007).…”