Congenital absence of one or several teeth
- Anodontia is a genetic or congenital (hereditary) absence of one or several temporary or permanent teeth. The upper lateral incisors are among the teeth that are most often congenitally missing with an incidence of ± 2% of the population.
- Unlike other teeth, such as the lower premolars that are also hereditarily missing with a similar incidence, the esthetic consequences are more significant for an anterior tooth, such as the lateral incisor, and this will influence the choice of the treatment plan to fill the void left by the absence of one or both lateral incisors.
- Another significant thing to consider is the replacement cost of a missing tooth if its replacement is preferred to closing the space orthodontically. Different prosthetic options allow the replacement of incisors (partial denture, Maryland bridge (resin bonded), bridge, crown supported by a dental implant). The cost of these prostheses can vary from several hundreds of dollars for the simplest removable partial prostheses that can replace both lateral incisors to more than 4000 to 5000$ per tooth for an implant-supported crown (for each lateral incisor).
- Several considerations need to be kept in choosing the ideal treatment for a young patient and the parents must be involved in this decision.
When upper lateral incisors are missing, there are 3 possible treatments:
- Open the spaces and replace the missing teeth prosthetically.
- Close the spaces by moving the posterior teeth forward. The canines will replace the lateral incisors and the premolars will replace the canines; the teeth will be “modified” or reshaped accordingly.
- A combination of both: opening on one side and closing on the other side.