Meeting the problem created by the congenital absence of maxillary lateral incisors

Abstract

T H E title of this report indicates definitely the problem involved. In the case to he reported, we know that this anomaly may be met in two ways ; viz., by closing the spaces occasioned by the absent teeth through the movement of such other teeth as are necessary to compensate for the lost tooth substance, or by opening up the spaces fully and replacing the absent teeth hy artificial means. The first plan of treatment was employed, and because of the satisfactory end-results obtained, and the technique employed in the use of orthodontic mechanism, it was deemed suitable for this occasion. History.-The patient, a girl fifteen years of age, was brought to me for treatment in April, 1933. Parental history was not complete because the fat her was not living, but the teeth and jaws of the mother were within the range of the normal. The patient's oral tissues were healthy, the incidence of caries was mild, and all the teeth were vital. The tongue was normal in size, the tonsils were free from pathologic involvement, the nose and lips in function, and the habit of breathing normal. Facial muscles were normal in tone, and the child generally presented every evidence of [rood health. Roentgenograms substantiated the clinical observation that the maxillary lateral incisors were absent. Attributed Etiology.-The congenital absence of the maxillary lateral incisors could be explained upon no other ground than that of heredity, but in view of the incomplete family history, this was but assumed. Diagnosis.-Photostatic facial and gnathostatic denture reproductions (in addition to roentgenograms) were utilized to record the case and served to confirm the conclusion that the anomaly was eugnathie in character, the denture alone being involved. As previously inferred, it was deemed expedient to use the canine teeth as substitutes for the absent lateral incisors, the first bicuspids for the canines, and shift the remaining posterior maxillary teeth in a manner to complete this compensating alteration.