MANAGEMENT OF ACONGENITALLY MISSINGLATERAL INCISORS Zeina Abou Zour
The maxillary lateral incisor is the 2nd most frequently missing tooth after the mandibular second premolar (not including the third molars) 20% of all missing teeth are the maxillary lateral incisors. Agenesis of both maxillary lateral incisors(bilateral) is more common then agenesis of only one (unilateral).(Symons,1991) Females are more affected then males.(Bergstrom,1977)
Agenesis of the maxillary lateral incisor is also linked with other dental anomalies such as : 1) Agenesis of other permanent teeth. 2) Microdontia of the contra lateral maxillary lateral incisor (Peg- shaped) and other permanent teeth. 3) Palatally displaced canines. 4) Distal angulation of the mandibular 2nd premolars.
Therefore the absence of one or more maxillary lateral incisor introduces a potential imbalance in the maxillary dental arch, obvious impact on facial aesthetics and it requires a complex and multidisciplinary treatment approach.
The 2 major treatment approaches for congenitally missing lateral incisors are: 1) Space Closure (Canine subistution) 2) Space Opening (To allow prosthodontic replacement)
Several factors need to be considered when deciding whether toclose the space left by a maxillary lateral incisor or to open thespace for a prosthetic tooth: 1) The presence of skeletal malocclusion. 2) Amount of crowding. 3) Facial profile. 4) Canine shape and color. 5) Lip level and gingival contour.