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Main Instructor Szu-Ting Chou
Shih-Chieh Chen
Department / Institution Department of Orthodontic, Kaohsiung Medical University Hospital,
Kaohsiung, Taiwan
Classification Case report
Congenitally missing teeth is a highly prevalent dental anomaly, the most commonly missing teeth are maxillary lateral incisors and second premolars.The treatment options are available for those patients missing lateral incisors include canine substitution, space closure by orthodontic treatment and a tooth-supported restorations or dental implants. This case report describes a patient with maxillary right lateral incisor missing, and we chose canine substitution to achieve optimal aesthetic.
The case was a 22-year-old female who was Angle’s Class II division1 malocclusion with maxillary right lateral incisor missing. Besides, the crowding anterior teeth over both arches and upper dental midline deviation were also noted. There was a supernumerary tooth under lower right first premolar. Cephalometric analysis showed that skeletal Class II jaw relation due to recessive mandible and
slightly hyperdivergent facial pattern. Diagnostic records revealed a convex lateral facial profile and lip incompetence. The treatment objectives were to improve the profile, replace maxillary right lateral incisor with canine, obtain bilateral Class I molar relationship, align the crowding teeth, obtain an efficient occlusal function.
Left upper first premolar, both lower first premolars and supernumerary tooth were extracted. Infrazygomatic miniscrew were inserted to correct upper midline. Resized , reshaped and occlusal adjustment of upper right canine were done during the treatment process. After 26 months of active treatment, overall dentitions were harmonious and occlusion was also stable.
A significant number of people in the population are congenitally missing permanent maxillary lateral incisors. Due to the obvious impact that this condition has on both dental and facial esthetics, the demand for orthodontic treatment by these people is high. For these patients, the treatment options
can be regain the space for an eventual restoration or closed the space with canine substitution depends on the evaluation of profile, state of occlusion, and the available space.
Orthodontic Treatment for Congenital Lateral Incisor Missing with Canine Substitution in Adult Patient - A Case Report.