Developmentally absent maxillary lateral incisors

Abstract

Objective To investigate the orthodontic management of patients with developmentally absent maxillary lateral incisors. Materials and methods A questionnaire was mailed to all orthodontists on the specialist list held by the British Orthodontic Society. Results The questionnaires (57.3% response) were analysed in two groups: Group 1 consisted of orthodontists who worked only in an orthodontic practice environment; Group 2 consisted of orthodontists who worked full-time or part-time in an environment where there were restorative dentists available for advice. Group 1 orthodontists were significantly more likely to recommend (p = 0.006) space closure in the management of developmentally absent maxillary lateral incisors. Group 2 orthodontists were significantly more likely to recommend (p = 0.004) minimal preparation bridges. Group 2 orthodontists also saw significantly more patients with hypodontia (p ≤0.001) and were significantly more likely to routinely obtain a restorative dentistry opinion before orthodontic treatment commenced (p = 0.001). Group 1 orthodontists were significantly more likely to assess the space required for implants by measurement between the crowns of adjacent teeth (p = 0.001). Group 2 orthodontists were significantly more likely to assess the space by use of intraoral radiographs (p = 0.019) or by measurement between teeth at the gingival margin (p = 0.029). Conclusions The management of developmentally absent maxillary lateral incisors by orthodontists in the UK appeared to be influenced by their practice environment, their experience and the availability of restorative dentistry advice. The influence of these factors was greater for the treatment options of space closure or replacement via resin-retained bridges but less so for implant treatment. This reinforces the need for multidisciplinary involvement.