As a general rule, the absent tooth will be the most distal tooth of any given tooth type . Lower premolars are the most frequently absent teeth with a prevalence of
2.6% (mainly symmetrical) followed by missing upper lateral incisors at 2% (more frequently bilateral than unilateral). The treatment options for missing upper lateral
incisors usually include space closure with canine substitution or space opening with subsequent restorative replacement. Only on rare occasions are patients either happy to accept the aesthetics of the missing lateral incisor, or is the space ideal for a direct prosthetic tooth or canine build up.So, When are Space Opening and Space Closure Appropriate?
When it is the lower second premolar (CML5) and the patient is young, the case can be closed easily - without losing too much anchorage - by using Hemisection. (Northway, W. Hemisection: one large step toward management of congenitally missing lower second premolars. Angle Orthod 2004; 74: 790-7.)
When the tooth is in the esthetic zone, for example the maxillary lateral incisor (CMU2) (Rosa M, Lucchi P, Ferrari S, Zachrisson B, Caprioglio A. Congenitally missing maxillary lateral incisors: Long-term periodontal and functional evaluation after orthodontic space closure with first premolar intrusion and canine extrusion. Am J Orthod Dentofacial Orthop 2016;149:339-48), space closure is the preferred method of treatment. In conclusion, age and esthetics dictate treatment propriety.
- Badges
- Science topic
- Similar topics
- Psychology
- Emotional Psychology
- Happiness