Journal of Oral Implantology April 2013 - (Page 187)

CASE REPORT Treatment of Congenitally Missing Maxillary Lateral Incisors: An Interdisciplinary Approach Brian J. Jackson, DDS* Mark R. Slavin, DDS Dentists have several treatment options when restoring patients with congenitally missing maxillary lateral incisors. Endosseous implant therapy combined with orthodontics can achieve predictable outcomes while meeting patient expectations. This case report exhibits an interdisciplinary approach involving orthodontics, implant surgery, and prosthodontics to resolve this common dental concern. Key Words: orthodontics, congenitally missing incisor, mini dental Implants (MDI), zirconium abutments INTRODUCTION R estorative dentists and orthodontists have various treatment plan options when restoring partially edentulous patients. However, the use of endosseous implants has become the treatment of choice for restoring patients with congenitally missing maxillary lateral incisors. Endosseous implant therapy can restore such patients with an acceptable esthetic and functional outcome as well as an enhanced clinical prognosis and patient satisfaction.1,2 The orthodontic phase must achieve several clinical criteria before the initiation of the implant surgical stage.3,4 The occlusion must ensure a stable posterior intercuspation with ideal overjet and overbite. The anterior edentulous area has to be created to allow for sufficient space between an implant and the adjacent tooth, thereby allowing for stable crestal bone levels and ideal dental papilla formation.5 In addition, this parameter allows for the establishment of the ideal width proportion of the maxillary lateral incisor to its adjacent central incisor. This relationship is referred as the ‘‘Golden Proportion,’’ which states that the width of the lateral incisor should be two-thirds the width of the central incisor.6 Finally, orthodontic treatment Slavin, Jackson & Burns, Utica, New York. * Corresponding author, email: bjjddsimplant@aol.com DOI: 10.1563/AAID-JOI-D-12-00025 should establish parallel or divergent roots to allow adequate space for surgical placement of endosseous implants.7 The case presented in this article demonstrates a multidisciplinary approach for the treatment of congenitally missing maxillary lateral incisors. The treatment plan included the extraction of the deciduous canines and orthodontic movement of the maxillary permanent canines into the ideal position. Endosseous implants were placed and restored in the ideal lateral incisor position with cement retained crowns. In addition, a residual diastema distal to the left maxillary canine was restored with a mini-endosseous implant.8,9 The treatment was completed over a 3 and a half year period, and the patient demonstrated a stable orthodontic, functional, and esthetic outcome. CASE REPORT A 43-year-old man presented to our office with bilateral congenitally missing maxillary lateral incisors (Figure 1). The patient’s medical history demonstrated no significant findings. The dental examination revealed permanent maxillary canines located in the lateral incisor position (#7 and #10) and the deciduous canines in the permanent canine location (#6 and #11). The diagnostic examination included a thorough medical history, dental history, diagnostic study models, panorex, cephalograph, site-specific periapicals, and photographs (Figure 2). Journal of Oral Implantology 187

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2013

Evidence-Based Practice or Practice-Based Evidence?
Evaluation of Optimal Taper of Immediately Loaded Wide-Diameter Implants: A Finite Element Analysis
A Prospective, Randomized Controlled Preclinical Trial to Evaluate Different Formulations of Biphasic Calcium Phosphate in Combination With a Hydroxyapatite Collagen Membrane to Reconstruct Deficient Alveolar Ridges
Retention of Implant-Supported Overdenture With Bar/Clip and Stud Attachment Designs
The Clinical and Histologic Outcome of Dental Implant in Large Ridge Defect Regenerated With Alloplast: A Randomized Controlled Preclinical Trial
Fluoride-Treated Bio-Resorbable Synthetic Hydroxyapatite Promotes Proliferation and Differentiation of Human Osteoblastic MG-63 Cells
Resonance Frequency Analysis of 208 Straumann Dental Implants During the Healing Period
A Simplified Technique for Solving the Transfer Problem of Implant-Supported Fixed Partial Dentures for Patients With Microstomia
Esthetic Evaluation of Single-Tooth Morse Taper Connection Implants Placed in Fresh Extraction Sockets or Healed Sites
A Technique for Improving the Retention of Dentures Retained by Ramus Frame Implants
Treatment of Congenitally Missing Maxillary Lateral Incisors: An Interdisciplinary Approach
Use of Titanium Mesh in Lieu of a Fixation Screw to Stabilize an Autogenous Block Graft: A Case Report
A Novel Approach to Preserve the Buccal Wall in Immediate Implant Cases: A Clinical Report
Implant Failure Associated With Actinomycosis in a Medically Compromised Patient
Replacement of Mandibular Posterior Teeth With Implants in a Postmandibular Resection Case: A Case Report
Zygomatic Implants/Fixture: A Systematic Review
An Overview of Immediate Root Analogue Zirconia Implants
Letter to the Editor
Reviews of Current Literature

Journal of Oral Implantology April 2013