1. MANAGEMENT OF A
CONGENITALLY MISSING
LATERAL INCISORS
Zeina Abou Zour

2.  The maxillary lateral incisor is the 2nd most frequently
missing tooth after the mandibular second premolar (not
including the third molars)
 20% of all missing teeth are the maxillary lateral
incisors.
 Agenesis of both maxillary lateral incisors(bilateral) is
more common then agenesis of only one
(unilateral).(Symons,1991)
 Females are more affected then males.(Bergstrom,1977)

3. Agenesis of the maxillary lateral incisor is also linked
with other dental anomalies such as :
1) Agenesis of other permanent teeth.
2) Microdontia of the contra lateral maxillary lateral incisor (Peg-
shaped) and other permanent teeth.
3) Palatally displaced canines.
4) Distal angulation of the mandibular 2nd premolars.

4. Therefore the absence of one or more maxillary lateral
incisor introduces a potential imbalance in the maxillary
dental arch, obvious impact on facial aesthetics and it
requires a complex and multidisciplinary treatment
approach.

5.  The 2 major treatment approaches for
congenitally missing lateral incisors are:
1) Space Closure (Canine subistution)
2) Space Opening (To allow prosthodontic
replacement)

6. Several factors need to be considered when deciding whether to
close the space left by a maxillary lateral incisor or to open the
space for a prosthetic tooth:
1) The presence of skeletal malocclusion.
2) Amount of crowding.
3) Facial profile.
4) Canine shape and color.
5) Lip level and gingival contour.