Abstract
Congenital tooth agenesis and tooth loss due to dental traumatism are some of the most common causes leading to rehabilitation of young patients with dental implants. The success of treating congenitally missing teeth with implant-supported prosthesis is no more guided only by osseointegration criteria. Nowadays the successful rehabilitation of these cases involves the adequate installation of dental implants with suitable prosthetic contour, color, and emergence profile closer to that found in natural dentition. Several treatment options are available for restoring patients with congenitally missing teeth such as maxillary lateral incisors. Fixed prosthodontics and orthodontics managements are considered acceptable treatment protocols. However, the gold standard rehabilitation of congenitally missing maxillary incisors is performed with implant-based prosthesis since no tooth wear neither extensive tooth movements are necessary. The present paper reports the treatment of a young adult woman with congenitally missing maxillary lateral incisors who underwent orthodontic treatment for improvement of teeth alignment and occlusal balance previous to dental implant surgery. This treatment also allowed appropriate space for the future lateral incisors crowns. Then, Morse-type conical implants were positioned and prosthetic abutments installed. Ceramic laminates were planned on central incisors in order to improve anterior aesthetics. All-ceramic crowns and laminates were made using lithium dissilicate-based ceramic (e-Max Press). The multidisciplinary association of orthodontic, implant and prosthetic techniques resulted in successful functional and aesthetic rehabilitation of the case, which was maintained after 1 year follow up.
Highlights
Dental agenesis is the absence or failure on teeth formation
An interdisciplinary approach should be observed during the diagnosis, prognosis, and treatment plan to provide a result with good predictability, reaching the esthetic and functional expectations of the patient (ZARONE, F. et al.2006)
Since missing lateral incisors are not rare in population and the multidisciplinary planning is fundamental on treatment success, the aim of the present paper was to report a case of maxillary lateral incisor bilateral agenesis in a young patient in which the multidisciplinary treatment allowed suitable resolution with excellent reestablishment of function and aesthetics
Summary
Dental agenesis is the absence or failure on teeth formation. Absence of permanent maxillary lateral incisors represents approximately 20% of all cases of dental agenesis, and this anomaly is more common to occur unilaterally (GALLER, et al 2009). Dental implants are commonly used to replace congenitally missing lateral incisors in young orthodontic patients (DE AVILA, et al 2012). If a patient presents congenitally missing maxillary lateral incisor, the width of the space for the implant and crown is determined by opposite lateral incisor. Since missing lateral incisors are not rare in population and the multidisciplinary planning is fundamental on treatment success, the aim of the present paper was to report a case of maxillary lateral incisor bilateral agenesis in a young patient in which the multidisciplinary treatment allowed suitable resolution with excellent reestablishment of function and aesthetics. All functional and esthetic adjustments should be ideally performed on the mock-up restoration previous to laminate confection, since thin restorations are delicate pieces that cannot be worn Checking of both full crown and ceramic laminates was carefully performed since direction of insertion of the restorations and fit must be verified before luting. The appropriate planning and multidisciplinary execution of the restorative steps allowed successful rehabilitation of the case (Figure 4)
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