Maxillary lateral incisor agenesis and microdontia: Minimally invasive symmetric and asymmetric esthetic rehabilitation

Maxillary lateral incisor agenesis is a condition that significantly compromises smile esthetics, which is particularly worrying in young patients. This article shows how the combination of non-invasive treatments and current restorative options may improve clinical outcomes following orthodontic treatment for symmetric and asymmetric maxillary lateral incisor agenesis and microdontia. Teeth were treated with conservative resin restorations in three separate cases: two of congenitally missing maxillary lateral incisors (i.e., unilateral and bilateral) and one of microdontia. After presenting the clinical results, this article summarizes how bleaching, enameloplasty, and bonding with composite resin can enhance esthetics and functions following orthodontic space closure. The cases reveal that carefully planned, methodically executed orthodontic and restorative approaches can achieve predictable, esthetic outcomes that will improve the patient’s self-esteem with a minimally invasive solution.

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

Case Reports in Dentistry ◽

10.1155/2020/8820711 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Sanjay Prasad Gupta ◽

Shristi Rauniyar

Keyword(s):

Treatment Plan ◽

Lateral Incisor ◽

Invasive Treatment ◽

Incisor Tooth ◽

Orthodontic Space Closure ◽

Space Closure ◽

Short Period ◽

Old Adult ◽

Maxillary Lateral Incisor ◽

Lateral Incisor Agenesis

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.

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

Journal of Molecular Biology Research ◽

10.5539/jmbr.v8n1p178 ◽

2018 ◽

Vol 8 (1) ◽

pp. 178

Author(s):

Hedaiat Moradpoor ◽

Farshad Rahimi ◽

Amin Golshah ◽

Narges Akbari ◽

Sahar Raissi

Keyword(s):

Patient Satisfaction ◽

Treatment Outcomes ◽

Orthodontic Treatment ◽

Dental Treatment ◽

Lateral Incisor ◽

Treatment Protocols ◽

Orthodontic Space Closure ◽

Space Closure ◽

Significant Difference ◽

Maxillary Lateral Incisor

Introduction: Due to the fundamental role of esthetics in the outcomes of dental treatments, especially in the anterior region (esthetic zone), the necessity of considering the matter of esthetics in clinical studies has become into focus in the current era. The aim of this study was the evaluation of esthetic outcomes of two treatment protocols in the treatment of congenital uni-lateral missing of maxillary lateral incisors as well as patient satisfaction from the treatment outcomes. Methods: in this study the sample size was 24 people (16 women and 8 men), These individuals sought dental treatment for replacement of the congenitally missing maxillary lateral incisor. Convenience sampling method was used and patients were divided into two groups regarding the kind of treatment they received. The two treatment protocols included: 1. Space closure by means of orthodontic treatment and then reshaping the canines; and 2. Space regaining by means of orthodontic treatment and replacing the lateral incisor with dental implants. Photographs of patients were acquired from the frontal view with retraction of the lips using digital cameras. Photographs were evaluated for Pink esthetic score. Results: No significant difference was detected between the two study groups in the evaluated factors in this study. Conclusion: The results of this study indicated that there is no significant difference in esthetic results in the two groups. Furthermore, both groups lead to similar results in patient satisfaction from treatment outcomes.

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Prevalence of Oral Microbial Flora during Orthodontic Space Closure: A Pilot Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45173.14141 ◽

2020 ◽

Author(s):

Abirami Selvaraj ◽

Sumathi Felicita ◽

Smiline Girija

Keyword(s):

Streptococcus Mutans ◽

Bacterial Count ◽

Lateral Incisor ◽

Orthodontic Space Closure ◽

Space Closure ◽

Significant Difference ◽

Maxillary Lateral Incisor ◽

Post Hoc ◽

One Way Anova ◽

Paired T Test

Introduction: Orthodontic treatment with fixed appliances especially during the retraction stage makes it challenging to maintain the oral hygiene. Attachments used, such as elastic chains, loops and springs, result in changes in the oral environment due to the accumulation of plaque and increase in the levels of bacterial count mainly Streptococcus mutans and Lactobacilli species. Aim: To determine the prevalence of oral microbial flora during orthodontic space closure. Materials and Methods: This was a cross-sectional pilot study conducted during the month of December 2019 which consisted of eight patients who were randomly selected among the age group of 18-25 years. Mean and SD of age in Males (4) and Females (4) were 22±2.16 years and 22.25±1.70 years, respectively and had reported to the Department of Orthodontics of a private dental college, Saveetha Dental College. In each patient, after 6-8 months of orthodontic treatment, plaque samples were collected only once around the orthodontic brackets at the cervical aspect of the maxillary lateral incisor, maxillary premolar, mandibular canine, mandibular premolar in 1st, 2nd, 3rd, and 4th quadrant respectively, by the method of cotton swabbing for the evaluation of micro flora. Independent paired t-test and One-way ANOVA with Post-hoc Tukey HSD test were done to estimate the prevalence of microorganisms at different sites. Results: Independent paired t-test showed highly significant differences in the levels of Streptococcus mutans when compared to Lactobacillus (p<0.001) with mean values of 4.8±2.5 and 23.1±9.2 for Streptococcus and Lactobacillus, respectively. One-way ANOVA with Post-hoc Turkey HSD analysis showed significant difference at the region of maxillary lateral incisor compared to other sites whereas Lactobacillishowed no significant differences between the various sites tested (p-value<0.001). Kappa statistics was performed which revealed an inter examiner reliability of 0.91. Conclusion: During orthodontic space closure, bacterial count of Streptococcus mutans showed a statistically significant difference between different sites (maxillary lateral incisor, mandibular canines, maxillary and mandibular premolars) with highest being the maxillary incisor region followed by that of mandibular canines. However, the incidence of Lactobacillusacidophilus did not show any difference between the various sites evaluated.

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Prosthetic replacement vs space closure for maxillary lateral incisor agenesis: A systematic review

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2016.01.018 ◽

2016 ◽

Vol 150 (2) ◽

pp. 228-237 ◽

Cited By ~ 18

Author(s):

Giordani Santos Silveira ◽

Natália Valli de Almeida ◽

Daniele Masterson Tavares Pereira ◽

Cláudia Trindade Mattos ◽

José Nelson Mucha

Keyword(s):

Systematic Review ◽

Lateral Incisor ◽

Prosthetic Replacement ◽

Space Closure ◽

Maxillary Lateral Incisor ◽

Lateral Incisor Agenesis

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An Alternative Approach for Space Opening in a Bilateral Maxillary Lateral Incisor Agenesis Patient using Miniplates

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-2200 ◽

2017 ◽

Vol 18 (12) ◽

pp. 1198-1205 ◽

Cited By ~ 1

Author(s):

Luiz R Paranhos ◽

Gladistone C Meros ◽

Aline Shoji ◽

Selly Suzuki ◽

Rodrigo Manfroi ◽

...

Keyword(s):

Case Report ◽

Negative Impact ◽

Functional Results ◽

Lateral Incisor ◽

Dental Occlusion ◽

Posterior Teeth ◽

Alternative Approach ◽

Maxillary Lateral Incisor ◽

Lateral Incisor Agenesis ◽

Smile Esthetics

ABSTRACT Aim This case report aimed to present an orthodontic mechanic alternative for space opening in a patient missing maxillary lateral incisors, using miniplates as anchorage, associated with self-ligating brackets. Background Dental agenesis affects the population causing esthetic and functional damages. The prevalence of missing maxillary lateral incisors should be considered for its significant rate and negative impact on smile esthetics. Case report This treatment was chosen based on the presence of balanced facial pattern, large canine anatomy, the need to improve dental occlusion to prevent further wear, and patient's esthetic complaint. To obtain the results, upper third molars were extracted, and two miniplates were installed to distalize the upper arch with no need for patient compliance or auxiliary devices. Self-ligating brackets were used to reduce friction on posterior teeth, thus facilitating movement with light force application. At the end of 19 months, the patient presented with class I good overbite and overjet, and adequate space for implant and prosthetics; also, good facial esthetic was maintained. Conclusion When indicated, space opening may provide excellent esthetics and functional results, and even more predictable results when skeletal anchorage miniplates are used to distalize all posterior teeth. Clinical significance Considering the high level of esthetic and functional compromise caused by dental agenesis, the technique hereby described represents a viable mechanic alternative within orthodontic possibilities. How to cite this article Meros GC, Shoji A, Suzuki S, Paranhos LR, Manfroi R, Claus J, Garcez A. An Alternative Approach for Space Opening in a Bilateral Maxillary Lateral Incisor Agenesis Patient using Miniplates. J Contemp Dent Pract 2017;18(12):1198-1205.

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Conservative Approach for Treatment of Maxillary Lateral Incisor Agenesis With the Deciduous Tooth Retained: 18-Month Follow-Up

Operative Dentistry ◽

10.2341/17-015-t ◽

2018 ◽

Vol 43 (2) ◽

pp. 121-127

Author(s):

CECM Lameira ◽

SR Mestrener ◽

NIP Pini ◽

FM Salomão ◽

AA Pesqueira ◽

...

Keyword(s):

Treatment Outcome ◽

Female Patient ◽

Multidisciplinary Approach ◽

Clinical Results ◽

Deciduous Tooth ◽

Lateral Incisor ◽

Conservative Approach ◽

Maxillary Lateral Incisor ◽

Lateral Incisor Agenesis

SUMMARY This case describes a female patient with agenesis of the maxillary right lateral incisor, with her permanent canine in its position and the deciduous canine retained. Additionally, she presented with a maxillary left peg lateral incisor. To solve her functional and esthetic complaints, a multidisciplinary approach involving perio-restorative procedures was proposed. Periodontal surgeries were performed to align the gingival contour, and the restorative approach utilized ceramic veneers. At the 18-month clinical and radiographic follow-up, the treatment outcome was stable, with maintenance of the clinical results achieved and without any sign of deciduous tooth resorption.

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Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial

European Journal of Orthodontics ◽

10.1093/ejo/cjaa075 ◽

2020 ◽

Author(s):

Matheus Melo Pithon ◽

Eduardo Otero Amaral Vargas ◽

Raildo da Silva Coqueiro ◽

Rogério Lacerda-Santos ◽

Orlando Motohiro Tanaka ◽

...

Keyword(s):

Oral Health ◽

Controlled Trial ◽

Phase 1 ◽

Self Esteem ◽

Lateral Incisor ◽

Phase 2 ◽

Space Closure ◽

Related Quality ◽

Health Related ◽

Maxillary Lateral Incisor

Summary Background The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine. Objective To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants. Subjects and methods A total of 44 people, aged 17–49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)—a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg’s Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study. Results All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001). Limitations Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error. Conclusions The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects. Clinical trial registration This study was not registered. Protocol The protocol was not published before trial commencement.

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