Missing upper lateral incisors: orthodontic considerations in young patients

Missing lateral incisors are usually discovered by age 9 when general orthodontic treatment needs are becoming apparent. Whether to close, open or maintain a space for a missing lateral incisor is an orthodontic decision that needs to fit within a total plan of dental management. Factors to consider include:- Skeletal base relationship, severity of crowding, overjet, overbite, position into which the canine erupts, crown sizes, crown shapes, crown colours, gingival contours, gingival display on smiling, patient and parent attitude toward options, availability of appropriate prosthetic services, time delay before effecting "final" prosthetic treatment, space and bone required for implant fixtures and financial and biological costs.