Objective: This case report represents inter-disciplinary treatment of two cases both with congenitally missing maxillary lateral incisor on one side and peg-shaped lateral on the other.
Methods: Of all the tooth agenesis cases, the incidence of congenitally missing lateral incisor is quite high. There are various alternatives for treating congenitally missing lateral incisors. Treatment options include using canines as substitutes, tooth- supported restorations, autotransplantation and orthodontically preparing adequate space for a single tooth implant. In our cases; considering arch length discrepancy, upper incisor inclinations and facial esthetics, it was decided to prepare adequate space for lateral implants on one side and to restore peg shaped lateral incisors prosthetically on the other side. To achieve this goal after levelling and aligning; opening the required space with coil-springs was initiated. As there were no contralateral teeth available to measure the mesiodistal width of the lateral; it was calculated according to the central incisors. After preparing enough space for both lateral incisors; consulting with oral implantology we decided to assess the skeletal maturity of the patients. Hand and wrist radiographs validated our implant placement time.
Results: Pre-prosthetic orthodontic treatment was successful. Enough space for both single tooth implants and restorations were prepared paying attention to the root divergence in the implant site. Implants were placed as intended and restorations were done successfully following orthodontic treatment.
Conclusions: Among all treatment options for congenitally missing lateral incisors, preparing adequate space for implants and restorations is the most conservative approach to provide esthetic and functional demands.