The treatment dilemma of missing maxillary lateral incisors-Part I: Canine substitution and resin-bonded fixed dental prostheses.

OBJECTIVE

Clinicians are faced with three common treatment options for the high frequency of missing or lost maxillary lateral incisors; canine substitution, a resin-bonded fixed dental prosthesis (RBFDP), or a dental implant. A review of current data and guidelines for treatment provide new insight into making the most appropriate selection.

OVERVIEW: The incidence of maxillary incisor agenesis and loss is prevalent. Both canine substitution and RBFDPs exhibit esthetic and functional advantages and disadvantages.

CONCLUSIONS

Most missing lateral incisors are detected at an early age as a result of congenital absence; therefore, proper treatment of these young patients is essential. Both canine substitution and RBFDPs can provide long-term success and esthetics when carefully executed. The decision should be based on the patient's expectations, their clinical presentation, cost, and the team's ability to provide the best long-term esthetic and functional prognosis for a specific patient.

CLINICAL SIGNIFICANCE: Patients regularly present for treatment of missing and lost maxillary lateral incisors. The functional and esthetic aspects of canine substitution and a RBFDP should be clearly understood relative to the clinical parameters of each patient prior to treatment.