Management of Congenitally Missing Maxillary Lateral Incisors with Canine Substitution: A Case Report

Introduction: The maxillary lateral incisor is the second most common congenitally absent tooth. This condition affects the maxillary anterior region and the aesthetics of the patient. To achieve optimal final esthetic, stable result and functional occlusion it is important to do the treatment planning with an interdisciplinary team of pediatric dentist, restorative dentist, periodontologist and orthodontist. Objective: The aim of this clinical report is to present a canine substitution with the help of mini-implants for en masse protraction of posterior teeth in an adolescent patient. Case report: A 14–year–old girl with hypodontia of her upper lateral incisors was treated with canine substitution. A complex interdisciplinary treatment approach was needed for the final recontouring of the canines. At the end of the treatment all the posterior teeth displayed good occlusion and tight interdental contacts. Conclusion: Every patient with missing maxillary lateral incisors needs an individualized treatment plan. Many factors should be considered. Restorative and periodontal specialists should be included in the final decision. Canine substitution can be an excellent conservative and esthetic treatment alternative. This case demonstrates that an absolute anchorage in the form of mini-implants is an effective method for protraction of maxillary posterior teeth.