Congenitally Missing Lateral Incisors; Orthodontic, Restorative, and Implant Approaches

Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence. Esthetically correcting congenitally missing maxillary lateral incisors is a common challenge that every orthodontist and dental team will face, and dentists must consider the treatment options that are most appropriate for each patient. This article discusses factors in determining whether to close an open space or to open enough space for a prosthetic treatment for congenitally missing maxillary lateral incisors. Further, the importance of a total treatment approach using an interdisciplinary dental specialty team to maximize function, aesthetics, and oral health is discussed.