The esthetic challenge of a malpositioned peg-shaped lateral incisor and a missing contralateral maxillary tooth: report of a case.

Abstract

A peg-shaped maxillary lateral incisor is an underdeveloped, small, malformed permanent tooth that erupts following the loss of a primary tooth. The maxillary lateral irregularly shaped incisor may be unilateral, on both sides of the central incisors, or accompanied by a missing lateral tooth on the contralateral side of the arch. Peg-shaped maxillary lateral incisors receive a great deal of attention, play a significant role in the displayed smile, and present a treatment challenge during all stages of a patient's life. Clinicians are called to plan the treatment and the timing from as early as the beginning of growth and development. Careful diagnosis may dictate postponing a treatment to later stages of life, especially if the tooth is malpositioned in the arch. The goal of this clinical report was to present a combined treatment for a case with a palatal malpositioned peg-shaped maxillary lateral incisor and a missing contralateral permanent maxillary lateral incisor, creating an esthetic challenge. Moving the malpositioned peg-shaped lateral tooth to the arch simplified and eased the final prosthetic treatment procedure, increasing the treatment predictability. The presented sequence of therapy further stresses the importance of incorporating minor tooth movement, without referring to a specialist, in the daily practice of a prosthodontic-oriented general clinic, by simple accessible means.