Preprosthetic interceptive orthodontics for missing lateral incisors in late mixed dentition

Different treatment alternatives are possible in the preprosthetic orthodontic management of missing of lateral incisors. We describe an efficient approach in a 12.11-year-old girl with incisors agenesis.

Treatment started with repositioning of the permanent canines in site 2 and the deciduous canines in site 3. After growth completion the deciduous canines will be extracted and replaced by dental implants. Permanent canines will then undergo reshaping in order to look like lateral incisors. The molar and cuspid relationships were finalised in Class I, with correct overjet and overbite. The mandibular and maxillary arch forms were acceptable without crowding and rotations. Opening the space offers different solutions for maintaining the alveolar bone for a future implant, with the advantage of a molar Class I relationship and a wider arch. It would also be possible to achieve distalisation of the permanent canine, following the Kokich's principle of alveolar development.

The described treatment is a valid alternative in the management of missing lateral incisors. This solution can avoid an additional orthodontic treatment in adulthood and allow easy management of the retention phase prior to final rehabilitation with single tooth implants