The maxillary cuspid and missing lateral incisors: esthetics and occlusion

When maxillary cuspids are moved mesially or if they are absent, it may be safe to assume: 1. There is no apparent change in facial contour. 2. The first premolar can serve as an adequate substitute for the cuspid, both functionally and esthetically. 3. If all spaces are closed, occlusal equilibration will usually be necessary to effect acceptable posterior occlusion. Mesiodistal contouring of the cuspids probably accentuates the problem since it seems to exaggerate any tooth size discrepancy which may exist between maxillary and mandibular teeth. 4. Unilateral space closure displays functional deficiencies more frequently on the side of closure. 5. Varying degrees of shade imbalance between the cuspid and central incisor can be expected, and the degree of contrast can be accurately predicted by using the mandibular cuspid as a guide. This is particularly important when the maxillary canines are impacted or unerupted.