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Congenitally Missing Laterals – Treatment Planning to Retention

Updated: Mar 22, 2023

Planning treatment for patients with congenitally missing maxillary lateral incisors typically centers around one primary question – open or close the edentulous space? Although this may seem like a straight-forward decision, it often is not. Depending on your specific influences or perhaps your education, you may have a stronger preference for one option over the other. If your objective is for a “titanium-free” diet, then you must fully understand all aspects of canine substitution. In contrast, if you prefer the esthetics of a single tooth implant, then you must recognize the details of space appropriation. Therefore, it’s important to consider the following questions when planning treatment for these patients: When is it appropriate to open or close space?, Which type of restoration is best for the patient – implant or fixed partial denture?, and Should these patients be monitored in the mixed dentition? This presentation will highlight the prospective treatment options for patients with missing maxillary lateral incisors: canine substitution, tooth supported restorations, and implant supported restorations. It will also demonstrate appropriate retention protocols when tooth replacement is the treatment of choice.


- Learning Objectives:

  • Understand when to open and when to close the missing lateral incisor space

  • Identify the limitations of orthodontic treatment for patients with missing laterals


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