Congenitally Missing Maxillary Lateral Incisors

Hi all, just been to the dentist and it seems two options are implants vs. canine substitution.

From my limited understanding of dental issues, I had it in my head that dental implants with orthodontic treatment to make space for implants would be better long term treatment.

They also suggested canine substitution as an option which I wasn't aware of. From the quick meeting, this seems to be a quicker, (cheaper?) option.

Not particularly pushed about the length of time with orthodontic work in relation to making space for dental implants but they were seeming to suggest that canine substitution would lead to a more aesthetic appearance which has me confused as number of teeth on top wouldn't match those below. Would this be made up by cosmetic bonding? I would be concerned about this approach as potentially more damaging to my oral health as I'd need my canines shaved.

Which is the preferred treatment for correcting this dental issue?
Anybody gone through this process?

vishal

There are differences of opinion regarding opening or closing space for missing lateral incisors. In Nothern America they prefer opening space but in Europe, we prefer closing space.
Current research suggests lay people prefer the aesthetics of space closure but special mechanics should be used for the best result, as well as bonding/veneers and or reshaping of other teeth.

Space closure, when done improperly, will not be aesthetic.

Main problem with dental implants is a blueish discoloration around the gums which happens very frequently and can appear horrible in some patients.

One opinion, which I share is, if you display gum when you smile, space closure is a must. However if you do not display gum then it can go either way.
Cost is also a consideration.

Best talk to your orthodontist for advice.

Oral Surgeon

vishal wrote: »

There are differences of opinion regarding opening or closing space for missing lateral incisors. In Nothern America they prefer opening space but in Europe, we prefer closing space.
Current research suggests lay people prefer the aesthetics of space closure but special mechanics should be used for the best result, as well as bonding/veneers and or reshaping of other teeth.

Space closure, when done improperly, will not be aesthetic.

Main problem with dental implants is a blueish discoloration around the gums which happens very frequently and can appear horrible in some patients.

One opinion, which I share is, if you display gum when you smile, space closure is a must. However if you do not display gum then it can go either way.
Cost is also a consideration.

Best talk to your orthodontist for advice.

Can't say that I'd agree with this...

vishal

vishal wrote: »

There are differences of opinion regarding opening or closing space for missing lateral incisors. In Nothern America they prefer opening space but in Europe, we prefer closing space.
Current research suggests lay people prefer the aesthetics of space closure but special mechanics should be used for the best result, as well as bonding/veneers and or reshaping of other teeth.

Space closure, when done improperly, will not be aesthetic.

Main problem with dental implants is a blueish discoloration around the gums which happens very frequently and can appear horrible in some patients.

One opinion, which I share is, if you display gum when you smile, space closure is a must. However if you do not display gum then it can go either way.
Cost is also a consideration.

Best talk to your orthodontist for advice.

Thanks for your advice. I don't show gum when I smile actually.

vishal

Oral Surgeon wrote: »

Can't say that I'd agree with this...

Reference is below but perhaps the information is out of date with better techniques? I have no experience with dental implants so I do not know.

Dueled E, Gotfredsen K, Damsgaard MT, Hede B.
Professional and patient-based evaluation of oral
rehabilitation in patients with tooth agenesis
Clin Oral Implants Res 2009;20:729
n = 179 implant crowns in 129 pats.
Agenesis of 2nd premolars and lateral incisors
Score 1: No blue-coloring ............ 43%
Scores 2-4: Blue-coloring or
visible crown margin 57 %

Dianthus

OP, who have you seen so far for consultation?
A dentist, an orthodontist, or both?

Dianthus

Dianthus wrote: »

OP, who have you seen so far for consultation?
A dentist, an orthodontist, or both?

I seen a dental surgeon and an orthodontist.

Fishorsealant

Substituting canines for laterals realistically means accepting posterior spacing unless you are going to use tads and loads of elastics. Not for me. Preserve the two space, align and replace if you can imo.. that being said have seen some very nicely reshaped 3s