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ePaper created 2017-09-06, 09:11:22 | version 1.38.0
lateral incisors agenesis treatment case report Fig. 37 Fig. 38 Fig. 39 Fig. 40 · Dental Class I. · Maxillary hypoplasia with lower arch dental compensations. Insuficient overbite and overjet. · · Upper spacing due to the laterals agenesis canines with first premolars (Figs. 26–28). · Finishing and occlusal settling (Figs. 29–31). · Verifying the implant site width (Fig. 32) and provisory implants and crowns place- ment (Fig. 33). (Fig. 18). · Upper midline deviated to the right. · Initial CR mounting (Figs. 19–21). Finally space analysis was carried out (Tables 1a & b). Treatment plan It was concluded that maxillary hypoplasia was an indication for space opening. Considering the young age of the patient, the skeletal pattern and the high demands regarding aesthetics, it was decided to: · Open spaces for two implants, but in the posterior area: 14 and 24. · Substitute the laterals with canines. · Temporary implants and crowns on teeth #14 and 24, until 18 years. · Reshaping the canines and first premolars to match the shape of the lateral incisors and canines: direct composites restorations on teeth #13, 11, 21, and 23. Treatment step by step: · Upper bracket placement (Fig. 22): level and align the gingival margins, and correct the torque on the upper canines who will substitute the lateral incisors. Implants space opening: substitute laterals with canines (Figs. 23–25) and substitute · Restorative phase At the end of orthodontic treatment, gingival margins were well aligned, midlines were cen- tred and canines and first premolars were posi- tioned to facilitate the restorative phase of treat- ment (Figs. 34–36). At this phase, a final CR mounting and wax-up was per formed (Figs. 37–39), as well as the anterior teeth res- torations (Fig. 40). Orthodontic treatment has improved both dental and facial aesthetics (Figs. 41–47) and the functionality of the occlusion (Figs. 48–52). Table 1a: Space analysis (Maxilla) Maxilla Crowding -5 mm Needed to create space for lateral incisors AP incisors position 0 mm Total -5 mm Table 1b: Space analysis (Mandible) Mandible Crowding AP incisors position Curve of SPEE Total -2 mm 0 mm -1 mm -3 mm ortho 2/2017 23