Management of alveolar deficit alveolar deficit in agenesis of a lateral incisor superior incisor
Prof. Federico Beron
Professor of Implantology and Periodontology at the University of Trieste.
Active member and editorial/web committee member of the International Piezoelectric Surgery Society. Dedicated to research in regenerative surgery, implantology, and periodontology; widely published in international journals and a frequent speaker at courses and conferences.
Key Opinion Leader (KOL) for Advan S.r.l.
Abstract
The second most common dental agenesis, following the more frequent mandibular third molar, involves the maxillary lateral incisors [1]. This common condition has a significant functional and aesthetic impact on the patient and presents a considerable challenge for the dental team.Several approaches have been reported for managing this condition, whether unilateral or bilateral.
These approaches, ranked from least to most invasive, include:
- i) conservative/prosthetic adaptation of the canine to replace the incisor and the first premolar for canine function (with or without orthodontic treatment);
- ii) orthodontic space creation for the incisor, followed by prosthetic replacement with a fixed crown (using various techniques);
- iii) orthodontic space creation for the incisor and fixed implant-supported rehabilitation. Nowadays, removable prosthetic rehabilitation is typically used only as a temporary solution when fixed provisional prostheses are not an option [2].
Although implant-supported rehabilitation offers certain advantages, it also presents several drawbacks, such as age limitations, surgical invasiveness, and the complex management of soft and hard tissue aesthetics, given the strategic location of the lateral incisor. Additionally, early implant placement should consider the long-term prognosis of the rehabilitation, given the patient’s age at the time of treatment. Agenesis also results in both soft and hard tissue deficiencies that need to be restored to ensure an optimal aesthetic and functional outcome for implant rehabilitation.
Therefore, the implant-based rehabilitation of a missing lateral incisor poses a significant challenge for both the oral surgeon and the prosthodontist.A 21-year-old Caucasian male, systemically healthy, was evaluated for implant placement in site 1.2 after a thorough assessment of alternative treatment options. The patient underwent 12 months of fixed orthodontic therapy to create space and achieve proper dental alignment.
