The clinical management of congenitally absent and malformed maxillary lateral incisors and second bicuspids.

A number of options have been presented to treat patients with congenitally absent (or malformed) MLI's and second bicuspids. Overall the treatment of choice was shown to be essentially dependent on diagnostic parameters, length of treatment time, facial esthetics and age of patient. Orthodontic space closure is the treatment of choice since it should result in a lasting natural healthy dentition. In prosthetic cases, implant-supported or otherwise, the skill of the practitioner and the quality of the prosthesis, plus the general health and the oral hygiene of the patient, would be important considerations to ensure longevity of the prostheses. TMJ dysfunction occurring during orthodontic treatment is a possibility. Procedures that may precipitate a dormant predisposition to these kind of difficulties should be carefully evaluated and/or compensated.