MESSAGE BOARD 2 Congenitally Missing #8 Townies come together to plot the best course of action for a young patient zxzxzx Post: 1 of 15 2/4/2019 The patient is a male, almost 14. The treatment plan is to extract the upper 4s and use palatal TADs to stabilize the upper 6s and open space for an implant in the space of #8. The dentist feels we should wait to start treatment until the patient is older because she is afraid opening space now and waiting to do the implant until the patient is older will result in the loss of bone in the area of the implant. Does anyone have any knowledge of that-or even better, a journal article or two on the subject? Thanks. n FIG. 1 FIG. 3 FIG. 5 FIG. 2 FIG. 4 christjl Post: 2 of 15 2/4/2019 Charlie, the answer to your question is probably yes, there will be continued bone loss in the area. This article is indirectly related to your question. [Editor's note: View this message board online to access this link.] The wider the mesiodistal distance between teeth, the greater the reduction in alveolar width. I think another answer is to review Vince Kokich's articles, because he used to suggest moving the tooth over and back would " create " more bone. I always wondered how long this crestal bone stayed in place. Have you considered removing the upper central incisor and restoring the two lateral incisors with composite resin? Reshape the canines similar to a missing lateral incisor case. I have done this in cases of maxillary central incisor loss due to trauma. It would avoid implants and prolonged treatment/waiting. n MARCH 2023 | 28 | ORTHOTOWN.COMhttp://www.ORTHOTOWN.COM