The lateral incisors agenesis is a congenital lack of these teeth. It is very common and it is often detected when the baby tooth does not fall or when it falls but the final tooth does not erupt. There are many ways of solving it.
Traditionally, this condition has been treated with conventional fixed prosthesis, grinding the neighbouring teeth to place porcelain crowns.
On one hand, this treatment has the advantage of being fast. However, it has a high biological price, since grinding the teeth causes them to lose their integrity and they become more susceptible to fracture, caries, etc. Due to this fact, sometimes a root canal is required before the grinding.
Using “Maryland” bridges, which are adhered to adjacent teeth, is another option.
Prostheses of this kind, which are very conservative, have the drawback that they come off easily, so they do not allow for normal masticatory function. Nevertheless, they are a very good choice as a temporary treatment for teenagers, who are too young for being treated with dental implants due to the fact that their jawbones have not completed their growth.
An orthodontic treatment might also be a good choice to close the gaps and move the canines to the place of the lateral incisors. On one hand, the drawback of this treatment is that the crown of the canine must be shaped so it looks like a lateral incisor. On the other hand, the advantage is that in certain cases, such as in overcrowding cases, the space between missing teeth can be used to align the rest of the teeth.
Currently, it is generally accepted that the best choice for replacing missing teeth is using dental implants together with a previous orthodontic treatment in order to align the neighbouring teeth and equitably distribute the edentulous spaces.
After the orthodontic treatment, usually the bone in the areas of agenesis is very thin. Thus, in these cases a proper implant treatment involves not only placing the implants, but also regenerating the bone simultaneously, and sometimes even performing a gum graft in order to give to the implant-supported restorations a more aesthetic appearance.
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