Orthodontic space opening in patients with congenitally missing lateral incisors. 2007

Anika Beyer, and Eve Tausche, and Klaus Boening, and Winfried Harzer
University Hospital Carl Gustav Carus, Department of Orthodontics, Technical University of Dresden, Dresden, Germany.

OBJECTIVE To determine the best time to begin orthodontic treatment for patients scheduled for implants to replace congenitally missing upper lateral incisors. The aim of timing is to maximize the amount of bone available for implant insertion and to improve incisors inclination. METHODS Seventy-three plaster casts of 14 patients with 26 missing lateral incisors were cross sectioned in the center of the planned insertion of the implant, and the implant profile was projected into the area at three different times: T1--beginning of orthodontic treatment, T2-- end of orthodontic treatment, and T3--implant insertion. Deficiency of alveolar ridge volume needed for implantation was determined by Leica Quin analySIS software. RESULTS An increase of ridge-volume deficiency from 0.26 mm(2) at T1 to 3.77 mm(2) at T3 was found. During orthodontic treatment the incisors protruded about 9.4 degrees (differing from the O1-NA standard of 7.5 degrees ). To ensure optimal esthetic and functional implantation results, time management concerning orthodontic treatment has to be done carefully. CONCLUSIONS To avoid a high degree of alveolar bone atrophy and the risk of relapse and retreatment, orthodontic treatment involving tooth movement should not be initiated before the age of 13 years. Furthermore, it is important to maintain anchorage of the upper incisors because high incisor proclination causes extra-axial stress on the implant. An interdisciplinary approach is essential to provide the best treatment outcome.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D008297 Male Males
D008336 Mandibular Diseases Diseases involving the MANDIBLE. Disease, Mandibular,Diseases, Mandibular,Mandibular Disease
D008439 Maxillary Diseases Diseases involving the MAXILLA. Disease, Maxillary,Diseases, Maxillary,Maxillary Disease
D009811 Odontometry Measurement of tooth characteristics.
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D002508 Cephalometry The measurement of the dimensions of the HEAD. Craniometry
D003758 Dental Implantation, Endosseous Insertion of an implant into the bone of the mandible or maxilla. The implant has an exposed head which protrudes through the mucosa and is a prosthodontic abutment. Dental Implantation, Osseointegrated,Endosseous Dental Implant Therapy,Endosseous Implantation,Osseointegrated Dental Implantation,Endosseous Dental Implantation,Implantation, Endosseous,Implantation, Endosseous Dental,Implantation, Osseointegrated Dental
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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