Periodontal, occlusal, and aesthetic outcomes of missing maxillary lateral incisor replacement: A systematic review and network meta-analysis.

INTRODUCTION

The aim of this systematic review was to determine the best treatment alternatives for patients with maxillary lateral incisor agenesis (MLIA) by comparing orthodontic space closure, implant and tooth supported dental prostheses by assessing studies that evaluated their periodontal, occlusal (function) and aesthetic results.

METHODS

The present systematic review was reported according to the indications of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) incorporating network meta-analysis, and the protocol was registered with PROSPERO (CRD42023487245). The PRISMA systematic search, without restriction on language or initial date, was carried out using electronic databases: MEDLINE (PubMed), Scopus and central register of controlled trials. To assess the aesthetic effects of the different treatment methods, an arm-based network meta-analysis was carried out.

RESULTS

The systematic search initially produced 1177 studies. At the end 10 studies met the inclusion criteria. These studies used various methods of treatment for maxillary lateral incisor agenesis including orthodontic space closure, implant-supported and tooth-supported dental prostheses. Data were extracted from the articles selected, and a network meta-analysis was carried out.

CONCLUSIONS

Within the limits of this network meta-analysis, no significant difference was found regarding the aesthetic results between orthodontic space closure or dental implant. Tooth-supported dental prostheses for MLIA reported worse scores in the periodontal indexes than orthodontic space closure treatment but the impact of orthodontic and prosthetic treatment on periodontal health remained contentious. Furthermore, no signs of TMJ dysfunction were observed in patients treated with either orthodontic space closure or prosthetic replacement.