Unilateral agenesis of the maxillary lateral incisor: space closure versus space preservation in growing patients

Abstract

A unilateral congenitally missing maxillary lateral incisor is often associated with a small or peg-shaped contralateral tooth. This form of hypodontia is also frequently combined with a generally undersized maxillary dentition, which could therefore be considered a paradigm for esthetic situations where problems of tooth position, size and form need to be connected and resolved. The space opening versus the space closure option should derive from a hierarchy of decisions. When we treat young patients, the restorative solutions should be obtained by a minimally invasive approach, which facilitates both the reversibility and ease of reintervention in the long term. (Semin Orthod 2020; 26:24-32)

A Comparative Study of Arch Width, Overjet and Overbite between Bilateral Congenital Missing Lateral Incisor and Normal Class I Occlusion

“…This study shows non-significant differences based on gender difference in overjet and overbite in the two groups. This result agrees with (24,25,26) : yet, it disagrees with (27,28) . The present study is important to the orthodontist to decide the most appropriate treatment plane to adopt in treating patients with bilateral congenital missing lateral incisors by open or closed the space with maintaining good esthetic to the patient by providing a correct arch width, overjet and overbite.…”

Esthetic Perception of Different Clinical Situations of Maxillary Lateral Incisor Agenesis According to Populations with Dental and Non-Dental Backgrounds: A Systematic Review and Meta-Analysis

“…Since then, despite evolution in technological and professional technical quality, doubts persist [ 39 ], mainly when treating young patients, especially in unilateral situations of MLIA, as subjects treated with implant-supported crowns will have inevitable long-term infraocclusion of the replaced lateral incisors [ 27 ] or will experience the need for periodic maintenance if treated with conservative restorative techniques [ 20 , 27 , 39 , 40 , 41 ].…”

Ausencia congénita de incisivos laterales superiores. Enfoques terapéuticos y sus resultados a largo plazo. Revisión descriptiva.

“…Trae consigo un compromiso estético y funcional, que necesita de un manejo multidisciplinario (1) . La prevalencia corresponde a un 0.8-2% de la población en general (2) .Considerando que el diagnóstico y el tratamiento suele ser en edad de crecimiento y desarrollo craneofacial, las alternativas terapéuticas para el reemplazo o sustitución de los dientes ausentes siguen aún en controversia (3) . Dentro de las alternativas terapéuticas para la sustitución de estos dientes, está el cierre de espacios mediante ortodoncia, con el reemplazo del incisivo lateral faltante por el canino adyacente; apertura de espacio para la colocación de un implante óseo integrado y su posterior rehabilitación; autotrasplante dentario y restauración con pónticos adheridos a las piezas dentarias adyacentes (4) .…”

“…Por último, la utilización de un puente adhesivo de un ala, cementado con resina podría ser una alternativa si el espacio disponible es reducido. Esta opción requiere de una preparación mínima, pero hay que considerar la elección del material, la superficie de unión, la técnica, el espesor del conector y su mantención (3) .…”