Absence Of Maxillary Lateral Incisors Research Articles

Clinical Evaluation of the Use of Mini-Implants to Replace Congenitally Absent Maxillary Lateral Incisors: A Short-Term Study

Aim: The aim of this study was to evaluate the treatment outcome of immediately restored mini-implants with a diameter of 2.5 mm one year after their use for rehabilitation of congenitally absent maxillary lateral incisors.
 Methodology: A total of 30 mini-implants (narrow ridge 2.5) were inserted in 23 patients (13 females, 10 males) with a mean age of 21.6 years (range: 16–38 years) at the implant center of Damascus University. The implants replaced congenitally absent maxillary lateral incisors. All implants were immediately restored with a non-functional provisional acrylic crown. The abutment part of the implant was prepared before crown cementation. The ceramic permanent crown was placed after three months. A health implant scale was chosen to evaluate implant success. A periapical standard X-ray was taken immediately upon bonding of the temporary crown as well as after one year of loading. Proximate bone loss was measured using Canvas 9 (ACD, 2004).
 Results: No implant was lost; thus, the one-year implant survival was 100%. Optimal survival was 93.6%. A statistically significant mean marginal bone loss was observed between baseline and 12 months (mesial: 1.06 ± 0.55 mm; distal: 1.05 ± 0.53 mm).
 Conclusion: A high one-year survival rate was documented for management of congenital missing maxillary lateral incisors using immediately loaded mini-implants, and these implants therefore provide a good alternative treatment option.
 How to cite this article: Alharissy M, Dayoub S. Clinical Evaluation of the Use of Mini-Implants to Replace Congenitally Absent Maxillary Lateral Incisors: A Short-Term Study. Int Dent Res 2012;2:27-32.
 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies - USP (HRAC-USP) - Part 2: Pediatric Dentistry and Orthodontics

The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics.

Analysis of crown widths in subjects with congenitally missing maxillary lateral incisors

The aim of the study was to test the hypothesis that the gene defect causing congenital absence of maxillary lateral incisors also causes narrowing of the dentition. A total of 81 patients with one or two congenitally missing lateral incisors were retrieved; 52 (64.2 per cent) patients presented bilateral agenesis, whereas 29 (35.8 per cent) had unilateral agenesis. The control group consisted of 90 consecutively treated patients. The largest mesiodistal crown dimension for all teeth, except for the maxillary second and third molars, was measured on plaster casts using a digital caliper to the nearest 10th of a millimetre. Statistical testing was performed using the analysis of variance model (P < 0.05) to test for differences in the mesiodistal dimension between the sample and the control group. Significance has been assessed using a P-value threshold level of 5 per cent. Agenesis of maxillary lateral incisors was found to be a significant predictor of tooth size. Patients who were missing maxillary lateral incisors had smaller teeth compared to control subjects, except for the maxillary right and left first molars. This finding was true for both unilateral and bilateral lateral incisor agenesis. Interaction between maxillary lateral incisor agenesis and gender was not significant. Patients with congenitally missing lateral incisors have narrower teeth than patients without any dental anomalies, except for maxillary first molars. A higher prevalence of microdontic contralateral incisors was found in patients with unilateral agenesis with respect to the control group.

Orthodontic treatment for a patient with hypodontia involving the maxillary lateral incisors

Developmental absence of maxillary lateral incisors is not uncommon in orthodontic patients. Treatment depends on a number of factors, including skeletal pattern, type of malocclusion, overjet, and the shape and color of the canines. Management can be broadly divided into space closure, space opening or redistribution, and prosthetic replacement. The purpose of this article was to report the treatment of a girl with an Angle Class I malocclusion with missing maxillary lateral incisors and severe crowding in the mandibular labial segment. Treatment included preadjusted fixed appliances, extraction of the mandibular first premolars, and space closure of the maxillary labial segment space with the canines substituted for the maxillary lateral incisors.

Relationship between bilateral congenital absence of maxillary lateral incisors and anterior tooth width

The objective of this study was to assess the relationship between anterior tooth width and the presence or absence of maxillary lateral incisors. Reference models of 106 subjects, 52 with bilateral agenesis of maxillary lateral incisors and 54 fully dentate controls, were examined. The sample was based on orthodontic patients treated over a 10-year period at Kent and Canterbury Hospital, Canterbury, Kent, United Kingdom. Maximum tooth widths were measured by using digital calipers (Tesa Technology, Renens, Switzerland). Individual tooth dimensions in the maxillary and mandibular anterior segments were reduced by 0.33 to 0.42 mm, respectively, in subjects with agenesis of the maxillary lateral incisors. Linear regression analysis confirmed that these differences have statistical significance (P <0.001). Isolated bilateral absence of maxillary lateral incisors is associated with reduced mesiodistal tooth widths in both the maxillary and mandibular anterior segments.

OLIGODONTIA OF PERMANENT DENTITION :A CASE REPORT

The present report highlights a case where a patient presented with midline diastema in the lower arch due to missing mandibular incisors and the esthetic and occlusal problems associated with permanent teeth Oligodontia. Congenitally missing teeth is the condition of having one or more missing teeth which cannot be observed clinically or in radiographic images. However, the prevalence of oligodontia in permanent teeth is reported to be 0.14%. There have been reports showing absence of maxillary lateral incisors, premolars, unilateral absence of mandibular incisors but agenesis of bilateral mandibular central incisors is not well documented in the literature. The early orthododntic intervention may eliminate some of the periodontal and restorative problems that could arise in these patients as adults. The aim of this case report is to document a case of congenitally missing permanent teeth along with other occlusal abnormalities and to discuss its clinical implications and management.

Implant Replacement of Congenitally Missing Lateral Incisors: A Case Report

Implants can readily be placed and restored in congenitally missing maxillary lateral incisor sites with predictable results if surgical, periodontal, and prosthodontic conditions are favorable. A case report using dental implants to replace bilateral congenitally absent maxillary lateral incisors for teenage female identical twins is presented.

Developmentally absent maxillary lateral incisors

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.

The management of developmentally absent maxillary lateral incisors – a survey of orthodontists in the UK

To investigate the orthodontic management of patients with developmentally absent maxillary lateral incisors. A questionnaire was mailed to all orthodontists on the specialist list held by the British Orthodontic Society. 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 <or=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). 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.

Developmental absence of maxillary lateral incisors in the Portuguese population

The aim of this study was to evaluate the prevalence and clinical manifestation of developmental absence of maxillary permanent lateral incisors in the Portuguese population. The study group comprised 16 771 patients observed between 1993 and 2000 at the Faculty clinic. Two hundred and nineteen patients were found to have missing upper lateral incisors (131 females and 88 males, with ages ranging between 3 and 71 years), a prevalence of 1.3 per cent in this population. Absence of these teeth was bilateral in 44.7 per cent of the patients; of the unilateral cases, 33 per cent occurred on the right side and 21.9 per cent on the left side. In children under 8 years of age (n = 12), two (0.26 per cent) also had developmental absence of the primary lateral incisors, one unilateral and the other bilateral. Among the 121 subjects with unilateral developmental absence, the contralateral maxillary lateral incisor was found to be microdont in 57.1 per cent (right lateral 23 per cent, left lateral 34.1 per cent), suggesting the possibility that microdontia represents a variable expression of the same developmental defect that results in absence.

An Anterior Tooth Size Comparison in Unilateral and Bilateral Congenitally Absent Maxillary Lateral Incisors

The purpose of this study is to compare the anterior tooth size width in patients with congenitally missing maxillary lateral incisors using the Bolton Index and divine proportion. The study sample consisted of thirty pairs of orthodontic models with unilateral (twelve patients; 7 females, 5 males) and bilateral (eighteen patients; 13 females, 5 males) absence of maxillary lateral incisors. The mean ages of the selected cases were 17.7 and 17.5 years, respectively. Descriptive statistics were used for the data analysis. The result showed the mean of the Bolton Index in cases with bilateral absence was closer to the Bolton mean than in cases with unilateral absence. In the unilateral absence cases the width of the existing lateral incisor (5.5 mm) was an average of 1.00 mm less compared to the standard mean (6.5 mm). The divine proportion showed the maxillary central incisors were small in width as indicated by the adjusted value or they were slightly larger in width than the mandibular central incisors. In cases with unilateral and bilateral absence the Bolton Index exhibited maxillary insufficiency, which was confirmed by evaluating the divine proportion of the maxillary and mandibular incisors. The result of the present study will be of great help to both the orthodontist, whether to open or close the space, and to the prosthodontist to restore the missing teeth of patients having missing maxillary lateral incisors.

Distribution patterns of primary and permanent dentition in children with unilateral complete cleft lip and palate.

To investigate the distribution patterns of primary and permanent teeth in the cleft area and the numerical variation in teeth in unilateral complete cleft lip and palate (UCLP) patients. A survey of the dentition in UCLP patients. Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan. 137 UCLP patients who met the following criteria: (1) have had at least one panoramic film taken, (2) the first panoramic film illustrates either primary or early mixed dentition. Evaluation of both permanent and primary dentition was available in 91 cases. Two evaluators performed independent evaluations of number and distribution of teeth in UCLP patients. The hypothesis that there are two odontogenic origins for maxillary lateral incisors was proposed to explain the occurrence of distribution patterns of dentition in the cleft area and to explain differences between primary and permanent dentition in UCLP patients. Four distribution patterns in the cleft area were identified in both the primary and the permanent dentition. In the primary dentition, placement of the lateral incisor distal to the alveolar cleft was the predominant pattern (pattern y, 82.4%), followed by absence of the cleft side maxillary lateral incisor (pattern ab, 9.9%), presence of one tooth on each side of the alveolar cleft (pattern xy, 5.5%), and placement of the lateral incisor mesial to the alveolar cleft (pattern x, 2.2%). In the permanent dentition, the most common pattern was the absence of the maxillary lateral incisor on the cleft side (pattern AB, 51.8%), followed by lateral incisor placement distal to the alveolar cleft (pattern Y, 46%), lateral incisor placement mesial to the alveolar cleft (pattern X, 1.5%) and the presence of one tooth on each side of the alveolar cleft (pattern XY, 0.7%). The discrepancy between the distribution patterns of primary dentition and permanent dentition successors is 57.1%. Variations in tooth number in both primary and permanent dentition of UCLP patients occurred most often in the cleft area. Abnormalities in the number of teeth (hypodontia or hyperdontia) outside the cleft area were more common in the permanent dentition than in the primary dentition (24.1% versus 4.4%). Four distribution patterns in the cleft area were identified in both sets of dentition. Our findings of distribution patterns in UCLP patients support the hypothesis that there may be two odontogenic origins for maxillary lateral incisors. Clinicians involved in managing the dentition of UCLP patients should consider the high frequency of numerical variation both in and outside the cleft area before starting dental treatment.

The orthodontic management of congenitally absent maxillary lateral incisors and second premolars: A case report

The orthodontic management of congenitally missing maxillary lateral incisors and second premolars is the subject of this case report. The primary orthodontic consideration was the maintenance of facial esthetics in a 12-year-old boy while consolidating, aligning, and coordinating the dental arches. The maxillary canines were orthodontically positioned in the lateral incisor spaces. The maxillary posterior teeth, including the deciduous second molars, were protracted to esthetic positions where they could function without interferences. The stability of the occlusion depends on the longevity of the maxillary deciduous second molar roots, which did not resorb during active tooth movement.

Panoramic radiographic survey of hypodontia in Australian Defence Force recruits

Comprehensive dental examinations and panoramic radiographs were used to determine the prevalence of hypodontia in 662 Australian Defence Force recruits. Of the sampled population, 6.3 per cent exhibited some degree of hypodontia (third molar agenesis excluded). Previous studies produced similar results. Third molar agenesis occurred in 22.7 per cent of the sample which again is in agreement with other studies. There was no statistical difference between the sexes in third molar agenesis; however, there was a significant difference with upper second premolars. Females exhibited an extremely low incidence of absence of maxillary lateral incisors.

Bilateral congenital absence of maxillary lateral incisors: A craniofacial and dental cast analysis

The dental casts and cephalometric records of forty-three patients exhibiting bilateral congenital absence of maxillary lateral incisors were evaluated to determine the nature and extent of any concurrent craniofacial and dental anomalies. The effects of bilateral orthodontic space closure were evaluated on a subsample of twenty-two cases. The data revealed normal dental arch length, arch width, overjet, and overbite, while significant tooth size discrepancies were found in several anterior and posterior teeth. Craniofacial deviations from normal included smaller maxillary length, smaller mandibular length, smaller anterior cranial base, and nasal bone. Vertical facial dimensions, both anterior and posterior, were significantly less, as was the mandibular plane angle. Soft-tissue examination revealed a 10 ° greater nasiolabial angle, which was increased a further 5 ° as a result of a mean incisor retraction of 1.5 mm during space closure. The craniofacial anomalies noted in the present sample were similar to those seen in persons with clefts and may reflect a common etiology related to a developmental disturbance during fusion of the facial processes in utero. In the treatment of patients with bilateral congenital absence of maxillary incisors, mechanotherapy designed to open the mandibular plane, increase the vertical dimension, and move the maxillary posterior teeth forward is recommended in order to prevent worsening the Class III tendency and to minimize maxillary incisor and upper lip retraction. Most cases will require significant mesiodistal reduction in tooth size in order to achieve an optimal occlusion.

Congenitally absent maxillary lateral incisors in the adult: a combined orthodontic and restorative approach to treatment

Abstract Early assessment is advisable for patients with congenitally missing maxillary lateral incisors. Adults who have not had early treatment often require orthodontic tooth movement. Careful coordination of orthodontic and restorative procedures reduces the overall treatment time. Two adult cases are described to illustrate the advantages of coordinating treatment.

Congenitally absent maxillary lateral incisors: treatment planning considerations.

Abstract No Abstract Available. Read at the Biennial Edward H. Angle Society meeting, August 1971, Seattle, Washington. This study supported by the University of Washington Orthodontic Memorial Fund.

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

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.

An inheritance of dwarfed or absent maxillary lateral incisors in three generations

J. Middleton Shaw found neither degeneration in form or size, nor absence of lateral incisors in the Bantu races, nor did Campbell in the Australian aboriginals, or Azoulay and Reynault in the Papuans. On the other hand, according to Hrdlicka, degenerate lateral incisors occur in about 3 per cent of white Americans, while Rose states that there is complete absence in 2-4 per cent of Central Europeans and in 6 per cent of Scandinavians. On the facts it is reasonable to assume that the defect is blastogenic rather than somatogenic, that is to sa.y, it is a transmitted characteristic rather than a simple failure of developmental process. Indeed, Fry holds the view that harelip and cleft palate frequently occur in the children of women with the defect. Herbert has reported a case of a woman, both of whose maxillary lateral incisors were missing; one of her children had a cleft palate on one side with the corresponding lateral incisor missing, while another child had both lateral incisors missing. Again Siemens, when investigating the subject, found no pair of similar twins in which one was affected and not the other.