Immediate maxillary lateral incisor implants with nonocclusal loading provisional crowns.

This clinical report series describes a treatment modality involving immediately placed dental implants in maxillary lateral incisor sites using noncemented immediate provisional crowns retained with calcinable copings (prosthetic complement used in preparing the metal for the definitive prosthesis). Ten implants were placed in eight patients for the replacement of maxillary lateral incisors: two immediate and eight corresponding to cases of agenesis. All were subjected to immediate rehabilitation with provisional acrylic resin crowns in nonocclusal loading. One implant failed 3 weeks after placement due to acute local trauma. The other nine remained functional within the mouth, with normal clinical and radiological characteristics after a minimum of 12-month follow-up. Immediate placement of implant fixed provisional restorations retained by friction in maxillary lateral incisors offers an esthetic solution, eliminates the need for a removable provisional restoration, and avoids implant failures associated with excess cement or screw loosening. Moreover, in the case of extractions, immediate placement and provisionalization of implants in maxillary lateral incisors can effectively optimize the peri-implant esthetic results by maintaining the existing hard and soft tissue architecture of the replaced tooth. As no cement or screws are required, and the provisional crowns are placed in nonocclusal loading, the risk of complications is minimized.     

A multidisciplinary treatment approach to a complicated maxillary dental trauma: a case report

Abstract – This case report describes the treatment of an 18‐year‐old male who lost two central maxillary incisors due to dental trauma. Because of a deep overbite and serious occlusal instability, the lost teeth 11 and 21 could not be replaced by a conventional fixed prosthesis. The vertical dimension of occlusion was increased using a Hawley‐type appliance over a period of 1 year. When sufficient intermaxillary space was gained the alveolar ridge was augmented with a mandibular symphysis graft. Nine months later two one‐stage non‐submerged implants (ITI, Straumann, Waldenburg, Switzerland) were inserted. After further soft tissue adaptation to two temporary acrylic crowns, porcelain veneers were placed on the two implants and the lateral incisors.     

A multidisciplinary treatment approach to a complicated maxillary dental trauma: a case report

This case report describes the treatment of an 18-year-old male who lost two central maxillary incisors due to dental trauma. Because of a deep overbite and serious occlusal instability, the lost teeth 11 and 21 could not be replaced by a conventional fixed prosthesis. The vertical dimension of occlusion was increased using a Hawley-type appliance over a period of 1 year. When sufficient intermaxillary space was gained the alveolar ridge was augmented with a mandibular symphysis graft. Nine months later two one-stage non-submerged implants (ITI, Straumann, Waldenburg, Switzerland) were inserted. After further soft tissue adaptation to two temporary acrylic crowns, porcelain veneers were placed on the two implants and the lateral incisors.     

Functional and esthetic rehabilitation of an adolescent cleft lip and palate patient

Many patients with clefts that also affect the alveolar ridge present with congenital absence of the permanent maxillary lateral incisors. This paper describes the treatment of an adolescent cleft lip and palate patient whose missing and unesthetic maxillary incisors were replaced by a combination of fixed and removable partial dentures.     

Multidisciplinary treatment approach with one piece implants for congenitally missing maxillary lateral incisors: a case report

Congenitally missing lateral incisors are a common clinical occurrence. Dental Implants have become a primary treatment option for replacement of these teeth. Many times in prosthodontic treatment planning a multidisciplinary approach is needed for a comprehensive out come. Prosthodontic treatment planning is needed prior to the patient's consultation and following treatment acceptance; the prosthodontist may need to coordinate treatment needs with other specialists, including an orthodontist and an implant surgeon. This article describes multidisciplinary management of a case presenting with spaced maxillary anteriors due to the congenitally missing lateral incisors. Treatment consisted of initial orthodontic space management to obtain adequate space for missing lateral incisors. Single piece, narrow diameter implants were placed in edentulous spaces on both sides. Aesthetic crown lengthening procedure was performed with all anterior teeth along with tissues surrounding the implants. Metal-ceramic crowns were given as definitive restorations, resulting into an acceptable aesthetic outcome.     

Bone augmentation and autogenous transplantation of premolar to the site of the fissure in a cleft palate patient

This article presents a case report of autogenous tooth transplantation to the site of the fissure, in addition to bone augmentation with graft of autogenous bone harvested from the iliac crest, performed in a cleft palate patient, who had insufficient bone volume. A non‐syndromic 10‐year‐old girl, with a unilateral cleft lip and palate, incisal transforamen fissures, agenesis of the maxillary left central incisor and both maxillary lateral incisors, was treated with autogenous bone graft in the cleft area. The orthodontic treatment plan was to replace the missing lateral incisors with the maxillary canines and to extract the mandibular first premolars. One of the mandibular premolars was extracted from its site with 2/3 of its root formation completed and transplanted to the maxillary left central incisor area. After orthodontic treatment, the anatomic crowns were characterized with composite resin. Autogenous tooth transplantation can be performed in the area of the fissure in young cleft palate patients, by performing bone graft augmentation before transplantation of the tooth, to gain sufficient recipient alveolar bone volume. A multidisciplinary approach is mandatory for the success of this clinical procedure, especially in cleft palate patients.     

Orthodontic possibilities for young patients with missing maxillary incisors

In the orthodontic treatment of young patients with missing maxillary incisors one should make an effort to avoid prosthetic solutions. This not only applies to situations with agenesis of maxillary lateral permanent incisors, but also to those cases in which maxillary incisors cannot be maintained after trauma. Standard solutions are presented for various sagittal jaw relationships and types and number of teeth missing. Specific rules have to be observed for the closure of spaces due to missing teeth in order to reduce the occurrence of papillae retraction and to place the substituting teeth in such a position that their crowns can be built up to look like the originals. This requires mesiodistal angulations that deviate from the standard ones, a proper distribution of crown width and in most cases a permanent retention with a palatally bonded thin multistranded wire.     

Esthetic enhancement of ceramic crowns with zirconia dowels and cores: a clinical report

There has been an increase in the use of esthetic metal-free ceramic crowns in restoring endodontically treated teeth or teeth with severe coronal destruction. Tooth-colored dowels and cores are used to enhance the esthetic result. This report describes the treatment of a patient with bilateral maxillary supernumerary lateral incisors, a severe malocclusion, and maxillary anterior tooth discoloration. Treatment included heat-pressed, metal-free ceramic crowns supported by zirconia ceramic dowel-and-core foundations.     

Maxillary lateral incisors of subjects with cleft lip and/or palate: Part 2.

Maxillary lateral incisors on the alveolar cleft were investigated in 431 cleft children registered in the Department of Orthodontics, Kyushu University Dental Hospital. The majority of primary maxillary lateral incisors were located on the distal side of the alveolar cleft in both unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP) subjects. Permanent teeth in UCLA tend to be located distally, but in UCLP they tend to be congenitally absent (p less than .01). The majority of primary teeth had normal shapes; the majority of permanent teeth were of intermediate type or were missing congenitally. One third of the UCLA and one half of the UCLP subjects who had primary maxillary lateral incisors were not followed by permanent replacements. The location of the majority of permanent maxillary lateral incisors tallied with that of the primary ones except in four UCLA, ten UCLP, and two bilateral cleft lip and palate (BCLP) subjects. Four UCLA and ten UCLP subjects who had primary lateral incisors on the distal side were followed by their permanent successors on the mesial side. Three UCLP and one BCLP subjects had permanent maxillary lateral incisors even though they had no temporary predecessors.     

Immediate Osseotite implant placement and immediate loading of a provisional restoration of maxillary lateral incisors

This article describes the immediate replacement of two maxillary lateral incisors teeth after extraction of the left lateral deciduous incisor at the same time with immediate Osseotite implants and immediate restoration. A traumatic dental extraction of a deciduos (b) lateral incisor was performed and a 4mm diameter x 15 mm 3i tapered Osseotite (Implants Innovations, Palm Beach, CA, USA) implant was immediately placed. The other lateral incisor place was treated at the same time and provisional temporary crowns were placed at the same surgery. The provisional crowns did not have any occlusal contact to reduce negative lateral forces. Final impression for definitive restoration was made five months after implant placement veneer ceramic crowns were bonded to the Gingihue abutment (3i, Implants Innovations, Palm Beach, CA) one month later. This article describes the use of immediate implants with immediate loading of Osseotite combined with provisional crowns resulted in an excellent outcome after a two-year follow up period.     

Dental implant treatment for two adjacent missing teeth in the maxillary aesthetic zone: a comparative pilot study and test of principle

Aim: The aim of this prospective comparative pilot study was to evaluate hard and soft peri‐implant tissues in patients with a missing adjacent central and lateral upper incisor treated with either one implant and an implant crown with a cantilever or two implants with solitary implant crowns up to 1 year after functional loading. Material and methods: In the “Implant–cantilever group”, five patients were treated with one dental implant in the region of the central incisor (NobelReplace Groovy Regular Platform). In the “Implant–implant group”, five patients were treated with two adjacent dental implants: at the position of the central incisor (NobelReplace Groovy Regular Platform) and at the position of the lateral incisor (NobelReplace Groovy Narrow Platform). Implant survival, pocket probing depth, papilla index, marginal bone level and patient satisfaction were assessed during a 1‐year follow‐up period. Results: No implants were lost during the 1‐year follow‐up. Mean pocket probing values of the implants were comparable between the two groups. Papilla index scores in both groups were relatively low, pointing towards a compromised papilla. Marginal bone loss was minimal and comparable between the groups. Patient satisfaction was very high in both groups. Conclusion: In this 1‐year prospective comparative study, no large differences in hard‐ and soft‐tissue levels could be shown between patients with a missing central and lateral upper incisor treated with either one implant and an implant crown with a cantilever or two implants with solitary implant crowns. To cite this article:
Tymstra N, Raghoebar GM, Vissink A, Meijer HJA. Dental implant treatment for two adjacent missing teeth in the maxillary aesthetic zone: a comparative pilot study and test of principle.
Clin. Oral Impl. Res. 22 , 2011; 207–213.
doi: 10.1111/j.1600‐0501.2010.02017.x     

Bilateral maxillary fused primary incisors accompanied by succedaneous supernumerary teeth: report of a case

Summary. A rare case of fusion between maxillary primary central incisors and supplemental teeth occurring bilaterally, accompanied by succedaneous supernumerary teeth, is presented. The patient was an 8·5-year-old Japanese boy. Intraoral examination revealed fusion of left and right maxillary primary central incisors to supplemental teeth, which had labial and lingual grooves. The maxillary primary lateral incisors were present. Radiographs showed that the fused teeth had separate roots, pulp chambers and root canals. There were two impacted supernumerary teeth and eruption of the permanent maxillary central incisors was delayed. Treatment was performed and the fused primary teeth and the impacted supernumerary teeth were extracted. After 6 months observation, surgical exposure of the two crowns of the permanent maxillary central incisors was performed. The teeth began to erupt and have since been kept under observation.     

An interdisciplinary treatment to manage pathologic tooth migration: a clinical report

Pathologic tooth migration (PTM) is a common symptom of periodontal disease and a motivation for the patient to seek dental therapy. The primary factors causing PTM are periodontitis and occlusal trauma. Comprehensive treatment for managing a moderate degree of PTM, including periodontal, orthodontic and prosthodontic treatment is described. Increasing the occlusal vertical dimension (OVD) with provisional restorations was attempted to create space for retracting maxillary flared teeth. Retraction and intrusion of maxillary flared incisors were achieved by a sectional orthodontic appliance. Splinted crowns from maxillary right lateral incisor to left lateral incisor were fabricated and connected to posterior prostheses by means of attachments to prevent relapse and to provide long-term stability.     

Prosthetic and orthodontic rehabilitation of a patient with missing maxillary lateral incisors: a case report.

IPS Empress 2 materials can be used for fabrication of short-span fixed partial dentures in the anterior region as well as single crowns. This clinical report describes the prosthodontic treatment of a 16-year-old male patient with missing permanent maxillary left and right incisors with IPS Empress 2 fixed partial dentures following orthodontic treatment.     

A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, post-treatment, and long-term follow-up records for the patient are presented.     

Macrodontia in association with a contrasting character microdontia

The dental, genetic, radiological and dermatoglyphic findings of a 19-year-old girl showing macrodontia of maxillary permanent central incisors in association with a contrasting character, microdontia of maxillary permanent lateral and mandibular primary central incisors and bilateral absence of maxillary first premolars and missing of the right mandibular second premolar and peg-shaped mandibular primary lateral incisors and canines were presented.     

Treatment of a patient with a crowded Class I malocclusion and a congenitally missing mandibular incisor

This case report describes the management of maxillary and mandibular crowding in a patient with facial esthetic concerns and a tooth-size discrepancy due to a missing mandibular central incisor. The treatment included extracting the remaining mandibular central incisor and the 2 maxillary first premolars. The mandibular canines were repositioned to substitute for lateral incisors, and the mandibular premolars were used as canines.     

Orthodontic intervention to a patient injured in a traffic accident

This case report describes the orthodontic treatment of a 29-year-old male who lost the maxillary bilateral central incisors as a result of a traffic accident. After emergency treatment for facial fracture by a plastic surgeon, the patient visited our orthodontic clinic. He had a concave profile, Class I molar relationship with slight maxillary retrusion, and crossbite of the maxillary bilateral lateral incisors. The interdental space was insufficient for prosthetic treatment of the missing maxillary incisors. Therefore, we planned to distalize the maxillary and mandibular molars to obtain appropriate interdental space for the prosthetic treatment of the missing teeth and to correct the crowding of the mandibular anterior teeth. The anterior crossbite was corrected, and appropriate overjet and overbite were obtained with functional occlusion after prosthetic treatment. This case report shows that the favorable occlusion and facial profile are obtained by the interdisciplinary treatment and discusses the specific problems which seen after the traffic accident.     

Improving orthodontic results in cases with maxillary incisors missing.

This article has aimed at providing information on how to improve clinical orthodontic results in cases in which maxillary central and lateral incisors are missing. Different sections deal with (1) treatment approach and mechanics, (2) details in finishing, (3) modifications of clinical tooth crowns by special procedures (grinding, composite "corners," gingivectomy), (4) functional considerations and root resorption, and (5) retention.