Jean C. Wu, MDSc, DDS; Cherilyn G. Sheets, DDS


August 12, 2011

A Woman With Congenitally Missing Lateral Incisors

A 19-year-old woman requested esthetic replacement of congenitally missing lateral incisors (teeth #7 and #10). Despite previous orthodontic treatment, the patient's occlusion remained in an open bite position, from tooth #5 to #12 and from #21 to #28 (Figure 1).

Figure 1a. Pretreatment anterior view. 1b. Pretreatment maxillary occlusal view.

Dental examination. On digital x-rays, a converging relationship was visible between the roots of teeth #6 and #8, and between teeth #9 and #11. This prohibited placement of implants in the current position (Figure 2).

Figure 2a. X-ray showing converging roots #6 and #8. 2b. X-ray showing converging roots #9 and #11.

Delayed passive eruption of the anterior maxillary teeth was evident, which resulted in excessive gingival display. However, this was not a concern to the patient. Slight horizontal alveolar ridge deficiencies were found, which were associated with the areas of the congenitally missing teeth (Figure 3).

Figure 3. Cast showing horizontal ridge deficiency.


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