Missing Maxillary Central Incisor Research Articles

Navigating the clinical ambiguity of implant placement in two young pubescent patients: an insight from two case reports

The horizon of implant dentistry has been ever-expanding owing to its long-term success in rehabilitating partially or completely edentulous cases. This perennial success and efficiency have encouraged clinicians to use osseo-integrated implants to replace teeth lost in children either due to trauma or congenital absence. Although a myriad of studies and publications suggest the placement of implants only after the attainment of skeletal maturity, as the growth-related changes such as remodelling, displacement, and mesial drift can put the future of implant and restoration in jeopardy, the use of implants in young pubescent or adolescent looks promising due to its evident psychological and social advantages over other contemporary alternatives such as a removable prosthesis or resin-bonded bridge. The first case report highlights a 16-year follow-up of a young girl treated at the age of 10 with an implant-supported prosthesis for the replacement of a missing maxillary left central incisor. The second case report centers around a 19-year-old teenage girl who underwent rehabilitation with a permanent fixed prosthesis, replacing her previous implant-supported temporary prosthesis. The implant was initially placed when she was 10 years old.

Pragmatic approach to rehabilitate maxillary teeth in aesthetic zone using resin bonded FDP- A case report

Resin bonded fixed dental prosthesis offers most conservative and cost-effective option with missing teeth in aesthetic zone specially when an implant prosthesis is not indicated. This case report describes a treatment option for the replacement of a missing maxillary central incisor using a double-retainer resin-bonded fixed partial denture (RBFPD), fabricated from zirconium dioxide (ZrO) ceramic. No clinical complications were observed at follow-up examination after placement of the prosthesis. Satisfactory functional and aesthetic results were achieved. A treatment modality using a ZrO ceramic RBFPD is an alternative for single anterior tooth replacement.

Influence of nanostructured alumina coating on the clinical performance of zirconia cantilevered resin-bonded fixed dental prostheses: Up to 3-year results of a prospective, randomized, controlled clinical trial

Statement of problemThe debonding of zirconia cantilevered resin-bonded fixed dental prostheses remains a technical complication because zirconia’s chemical inertness impedes adequate surface preparation for bonding. Limited clinical evidence on the performance of various pretreatment methods for the bonding surface of zirconia resin-bonded fixed dental prostheses is available. PurposeThe present prospective, randomized, controlled clinical trial aimed at evaluating the performance of zirconia resin-bonded fixed dental prostheses prepared with nanostructured alumina coating. Material and methodsThe study adopted a prospective, randomized, controlled, double-blind (patients, operator) design to compare the performance of nanostructured alumina coating with that of conventional airborne-particle abrasion. Twenty-seven healthy patients needing a replacement of a missing maxillary or mandibular central or lateral incisor were screened and rated to be eligible, and 31 zirconia cantilevered resin-bonded fixed dental prostheses were randomly allocated into 1 of 2 groups. The first group (n=15), where the restoration bonding surface was airborne-particle abraded with 50-μm alumina, served as a control group. In the second group (n=16), the restorations were pretreated with nanostructured alumina coating. Treatment and data collection were standardized. The primary outcome evaluated was the survival of the RBFDPs as defined by the restoration not debonding. The Kaplan-Meier analysis of cumulative survival was performed, and nonparametric tests were used to determine patient-specific differences between both study groups (age, sex, restored arch, tooth replaced, bonding surface area) (α=.05). Retainer wing surfaces of debonded resin-bonded fixed dental prostheses were inspected under a scanning electron microscope. ResultsWithin a mean ±standard deviation observation period of 22.4 ±7.7 months (minimum, 8.3; maximum, 37.9 months), 3 debondings occurred, and the survival rate was 90.3%. The survival rate was 93.8% for the nanostructured alumina coating and 86.7% for the control group, with no statistically significant differences (log-rank, P=.54). No patient-specific differences were found between study groups (P>.05). As per the scanning electron micrographs, the majority of the nanostructured alumina-coated surfaces had large areas of nanostructured alumina residue, whereas the airborne-particle abraded surfaces exhibited predominantly adhesive failure with less cement residue. ConclusionsOver a mean observation period of 2 years, both zirconia pretreatments showed promising and comparable clinical results; therefore, nanostructured alumina coating could be regarded as a viable alternative pretreatment method to airborne-particle abrasion.

Finite element analysis of a one-piece zirconia implant in anterior single tooth implant applications.

This study evaluated the von Mises stress (MPa) and equivalent strain occurring around monolithic yttria-zirconia (Zir) implant using three clinically simulated finite element analysis (FEA) models for a missing maxillary central incisor. Two unidentified patients' cone-beam computed tomography (CBCT) datasets with and without right maxillary central incisor were used to create the FEA models. Three different FEA models were made with bone structures that represent a healed socket (HS), reduced bone width edentulous site (RB), and immediate extraction socket with graft (EG). A one-piece abutment-implant fixture mimicking Straumann Standard Plus tissue level RN 4.1 X 11.8mm, for titanium alloy (Ti) and Zir were modeled. 178 N oblique load and 200 N vertical load were used to simulate occlusal loading. Von Mises stress and equivalent strain values for around each implant model were measured. Within the HS and RB models the labial-cervical region in the cortical bone exhibited highest stress, with Zir having statistically significant lower stress-strain means than Ti in both labial and palatal aspects. For the EG model the labial-cervical area had no statistically significant difference between Ti and Zir; however, Zir performed better than Ti against the graft. FEA models suggest that Ti, a more elastic material than Zir, contributes to the transduction of more overall forces to the socket compared to Zir. Thus, compared to Ti implants, Zir implants may be less prone to peri-implant bone overloading and subsequent bone loss in high stress areas especially in the labial-cervical region of the cortical bone. Zir implants respond to occlusal loading differently than Ti implants. Zir implants may be more favorable in non-grafted edentulous or immediate extraction with grafting.

Treatment of a transmigrated and an impacted mandibular canine along with missing maxillary central incisor: A case report

IntroductionTreatment of a case with impacted canines is complex and numerous options are available ranging from disimpaction to forced eruption. ObjectiveThe objective of this case report was to describe the treatment of a 19-year-old male, with a skeletal Class II, dental Class II Division 1 malocclusion, prognathic maxilla, proclined maxillary incisors, with missing left maxillary central incisor and bilateral mandibular canine impaction. MethodologyThe orthodontic treatment plan included forced eruption of the impacted canines and conversion of maxillary left lateral incisor to central incisor. ConclusionProper diagnosis and implementation of orthodontic biomechanics can minimize the amount of prosthetic and surgical intervention needed in the management of transmigrated canine and smile designing.

上顎前歯欠損にブリッジ修復を適用し審美性の回復を行った１症例

上顎前歯欠損にブリッジ修復を適用し審美性の回復を行った１症例

Replacement of missing tooth in esthetic zone with implant-supported fixed prosthesis

In the anterior region, the common reason for tooth loss is due to traumatic injury or congenital anomaly. Loss of a single tooth may cause functional and esthetic deficits to the patient. There are different treatment options available for replacing a missing incisor. Implant dentistry should be considered as first treatment alternative for replace a missing tooth. This case report presents the replacement of a missing maxillary left central incisor in a compromised site with dental implants along with bone graft followed by frenectomy to obtain a good clinical result and for better function and esthetics of the patient.

Aesthetic implant: A new era of aesthetic dentistry

The dental implant is used to replace the natural tooth system. It requires comprehensive preoperative planning and precise surgical execution. In this case report, a 45 year old male presented with missing upper left maxillary central incisor which was extracted 5 months back. He had discomfort during function and unwillingness to smile. He wanted to replace that edentulous area. The treatment options for replacing the missing tooth were discussed with the patient. Finally, with patient's consent the decision was made to replace that edentulous area with an implant supported porcelain fused to metal prosthesis in an esthetic manner. Recall visits exhibited patient's high-level confidence of smile with optimum satisfaction and successful aesthetic outcome.

Replacement of missing central incisor with single implant-supported fixed prosthesis

Loss of a single anterior tooth causes a major functional and aesthetic concern to the patient. There are different treatment options available for replacing a missing incisor. If the economic status of the patient permits, it is the responsibility of the clinician to explain the benefits of dental implant to replace a single missing tooth. This case report describes the replacement of a missing maxillary left central incisor tooth of a patient with dental implants for better function and esthtics.

Philtral Width and Width of Maxillary Central Incisor A Correlational Analysis in dentate adult human subjects

Statement of the problem: The estimation of the width of a missing maxillary central incisor is of a paramount importance for prosthodontic applications. Several facial anatomic land marks have been used to accomplish this purpose with varying degrees of certainty .This study explores the possibility of using labial philtrum to correlate and predict the width of maxillary central incisor. Aim : 1. To estimate the correlation between the width of maxillary central incisor and the width of the philtrum. 2. To predict the width of maxillary central incisor utilizing the philtrum width as a guide. Methodology : A prospective, observational, open label study design was performed to evaluate the correlation between the maxillary central incisor width and philtral width in 200 Indian dentate adult human subjects satisfying the inclusion and exclusion criteria. The maxillary central incisor width denoted as variable y and the philtral width as variable x and width was measured in millimetres and the values were subjected to statistical analysis to estimate correlation and regression. Statistical Analysis: Pearson's correlation coefficient was worked out (r) and a regression equation was formulated and analyzed using the SPSS statistical software. The correlation coefficient worked out was r = + 0.99, coefficient of determination r 2 = 0.96 and the regression intercept was -5.99. Mean central incisor width was 8.5 ±0.65 mm and mean philtral width was 14.4 ±0.42 mm. Inference: A strong positive correlation between the width of the philtrum and width of maxillary central incisor was observed (r = + 0.99). The maximum philtral width subtracted by 6 mm will provide the estimate for the width of maxillary central incisor.

Replacement of Missing Maxillary Central Incisor with an Osseointegrated Implant-supported Prosthesis from an Orthodontic Perspective: A Multidisciplinary Approach

Replacement of Missing Maxillary Central Incisor with an Osseointegrated Implant-supported Prosthesis from an Orthodontic Perspective: A Multidisciplinary Approach

Treatment Strategies for Missing Maxillary Central Incisor—An Orthodontist's Perspective

The loss of maxillary central incisors at an early age has psychological, esthetic, and functional implications. Multiple treatment options are available for replacing missing central incisors. The management demands a multidisciplinary approach involving the orthodontist, prosthodontist, and periodontist. Treatment planning requires consideration of a variety of clinical and nonclinical factors. This clinical report attempts to demonstrate different strategies for the management of unilaterally and bilaterally missing central incisors.

Management of Class III Malocclusion with Missing a Maxillary Central Incisor (A Case Report)

Aim: The present case report describes the orthodontic treatment of a patient with a missing maxillary right central incisor and a skeletal Class III jaw relationship due to a retrognathic maxilla. Materials and Methods: Treatment was conducted in two phases, with a removable appliance and Delaire’s facemask used in the first phase and a fixed appliance used in the second phase. Mesial movement of the maxillary canine, first premolar, second premolar and first molar was achieved sequentially over the two phases of treatment. After 36 months, the anterior space was closed, and good intercuspation and interproximal contacts and satisfactory root parallelism were achieved. Finally, interproximal spaces were closed orthodontically, the crown of the upper right lateral incisor was anatomically modified to imitate a central incisor, the right maxillary canine was reshaped slightly along the incisal edge, and a gingivectomy was performed in the maxillary canine area to achieve normal vertical crown proportions. Results: Post-treatment intraoral photographs show satisfactory dental alignment and acceptable overjet and overbite. The patient was satisfied with her teeth and profile. Conclusion: The combination of maxillary protractor and fixed appliance successfully corrected the skeletal Class III malocclusion and achieved forward mesial movement of the maxillary posterior teeth.

Orthodontic movement of a maxillary central incisor across the midline: a case report

Introduction A maxillary central incisor is the tooth most commonly affected by dental injury [1]. A missing maxillary central incisor can cause esthetic, psychological, and functional problems. The missing incisors need to be replaced with prosthesis such as implants. Orthodontic space closure [2] or autotransplantation with an immature premolar [3] can

Oral Rehabilitation of Missing Maxillary Central Incisor in a Growing Child- A Clinical Dilemma

The management of missing permanent teeth in a growing child differs significantly from that of an adult. In adults consideration is given to function, aesthetics and appliance design. In children also similar considerations are required; however there is an additional factor to be considered i.e growth. Different treatment options for the replacement of missing permanent tooth includes fixed partial dentures, removable partial dentures and dental implants. But in children due to the growth factor all these treatment modalities should be reconsidered. Therefore in young patients where prosthetic replacement is mandatory, the aim should be to provide temporary prosthesis that fulfils aesthetic demand, function and does not cause any tissue damage throughout the growth period. The present case discusses the use of resin retained restoration as a temporary tooth replacement option in a growing child where an alternative treatment after growth completion is planned.

Resin-bonded Bridge: Conservative Treatment Option for Single Tooth Replacement

Resin-Bonded Fixed Partial Dentures (RBFPD) was introduced to dentistry around 40 years ago. The typical design of resin-bonded fixed partial denture is characterized by conservation of tooth structure of abutment compared to fixed treatment. This article presents a case report of a patient who reported with missing maxillary central incisor. Multiple treatment options are available for replacement of missing tooth. Use of conventional fixed partial denture in such a situation is criticized because modern dental practice revolves around the principle of preservation of tooth structure. So in such cases resin bonded fixed partial denture is best treatment option.

Esthetic improvement in the patient with one missing maxillary central incisor restored with porcelain laminate veneers

This article describes esthetic improvement in a patient with a missing maxillary left central incisor. Space analysis of the anterior dentition showed that minor tooth rearrangement was needed. Optimal space distribution for restorations was attained by orthodontic treatment. Through transforming tooth shape with porcelain laminate veneers, the maxillary left lateral incisor was transformed into central incisor and the maxillary left canine into a lateral incisor. The maxillary right central incisor was also restored for esthetic improvement. In a case of changing a tooth shape with porcelain laminate veneers, pre-treatment evaluation, space analysis and diagnostic wax-up are important factors.

Beware the solitary maxillary median central incisor

The incidence of a solitary maxillary median central incisor (SMMCI) tooth in the general population is low, in either the primary or secondary dentition. The most common cause of a missing maxillary central incisor is trauma, or more rarely hypodontia. However, SMMCI is also a recognized genetic anomaly and affected individuals can be carriers for a potentially more serious condition affecting midline development of the brain and face, holoprosencephaly (HPE). The presence of an SMMCI of unknown aetiology is therefore considered a risk factor for HPE, even in the absence of any other clinical signs. The orthodontist may be responsible for diagnosing cases of SMMCI with no obvious cause, and in these subjects due consideration should be given to referral for the appropriate genetic testing and counselling.

A Procera® Custom Abutment Fabricated by Scanning the Provisional Abutment

Patient: The patient was a 56-year-old male presenting with a missing maxillary right central incisor. Subsequently, an endosseous implant was fiited. After a 6 month healing period, a provisional abutment was fabricated to an optimal shape on the provisional titanium component. After confirming custom-guided tissue healing and appropriate emergence profile, the provisional abutment was scanned using the Procera® scanner. The CAD/CAM custom titanium definitive abutment and the definitive porcelain fused to the metal crown were delivered as an esthetic implant restoration.Discussion: Compared to conventional procedures, the following advantages can be seen: 1. There is no access hole in the provisional restorations. 2. Appropriate soft-tissue contours can be induced by modification of provisional restoration. 3. A definitive abutment with the identical contours can be reliably obtained using CAM. 4. An extra temporary plastic component is not necessary. The disadvantages are: 1. The provisional abutment using the temporary cylinder has to be made. 2. The Procera® scanner has to be set up chair-side. 3. The patient has to wait during scanning.Conclusion: A custom Procera® abutment with an ideal emergence profile can be fabricated by scanning the provisional abutment with appropriate soft-tissue contours.

Outcome of orthodontic space closure with a missing maxillary central incisor

Orthodontic space closure is one of the treatment alternatives when a maxillary central incisor is missing. Because no systematic analysis of such treatment results is available, a sample of 20 consecutively treated patients was examined in a follow-up study. All patients had received orthodontic treatment with the objective of closing the space for the missing central incisor. Biologic features and the clinical appearance of the recontoured lateral incisor (test tooth) replacing the missing tooth were compared with the neighboring intact central incisor, which served as control tooth. The patients’ opinions regarding the treatment and the result were recorded in a questionnaire. The position of the examined teeth and the appearance of the surrounding soft tissues were similar in the test and control teeth. However, in some patients (25%), certain aspects of the recontoured incisor crown (such as the width at the gingival margin) mismatched the appearance of the controls. A somewhat increased mobility and probing pocket depth on the mesial aspect was recorded for some test teeth. No obvious detrimental effects were observed on the radiographs. Most patients expressed satisfaction with the treatment result. It is concluded that orthodontic mesialization of the lateral incisor to replace a missing central incisor is a valid treatment modality, if the indications for such treatment are present and careful attention to detail in orthodontic and restorative treatment is exercised.