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ePaper created 2017-12-19, 09:12:26 | version 1.38.0
case report _ lateral incisors agenesis treatment Fig. 22 Fig. 23 Fig. 24 Fig. 25 Fig. 26 Fig. 27 When is canine substitution appropriate? _Occlusal considerations _ Class II free of mandibular crowding: mo- lars in full Class II and premolar brought forward to act as the canine, while re- maining in a Class I relationship with the lower canine; _ Class I with sufficient mandibular ante- rior crowding that would necessitate pre- molar extractions on the lower arch. _Profile _ Flat; _ Slightly convex profile. _Canine size, shape and colour _ The width at the cementoenamel jun- ction: the wider the tooth, the more diffi- cult it will be to mimic a lateral incisor; _ Colour: canines are the teeth that are the most saturated with chroma. A canine that is smaller in shape and does not have an oversaturation of chroma would make an excellent candidate for canine substitution. Fig. 28 Fig. 29 _Smiling lip level _ Depending on how high the smile line is, it may show the canine eminence; _ Large canines often have an obvious root prominence, and high lip levels may reve- al that there is an unnatural eminence in the lateral sight. _Clinical case A 13-year-old patient complaining about the ae- sthetic aspect of her smile was sent to my office by a general dentist with a diagnosis of the bila- teral lateral incisors agenesis. The treatment started with an aesthetic analysis of the patient’s face (Figs. 4–10), which was as follows: _ Square face; _ Slight facial asymmetry, with menton de- viated to the right; _ Maxillomandibular biretrusion (Fig. 10); _ Correct curl of the upper lip; _ Left side of the face is more flat compa- red with the right side; _ Right eye slightly higher; _ Insufficient display of the upper anterior teeth with lips in repose. Then occlusal analysis (Figs. 11–21) was performed: Fig. 30 Fig. 31 Fig. 32 Fig. 33 Fig. 34 Fig. 35 Fig. 36 22 cosmetic dentistry 4_2017