Category Archives: Diagnostic Procedures and Case Analysis

Management of congenitally missing lateral incisors

Summarized by : Dr Hani Alhebshi .

Three treatment options for replacing missing lateral incisors :

1.Canine substitution. ( Space Closure ).

2.A tooth supported restoration ( Space Opening ).

3.A single tooth implant ( Space Opening ).


The primary consideration to choose one option is to choose the most conservative one or the least invasive according to each case. 

congenitally missing lateral

Canine substitution :

Select the appropriate patient for canine substitution according to several criteria :

A. Malocclusion :

Two types of malocclusion can accept canine substitution according to

  1. Class II with no crowding in mandibular arch.In this pattern molars remain in class II and premolars are located in traditional canine position.
  2. Class I with crowding in lower arch that necessitate extraction.

Diagnostic wax up will greatly help the orthodontist and the dentist to evaluate the final occlusion and how much canine reduction is necessary.

B.Profile :

  • The ideal profile to accept canine substitution is straight profile or mildly convex. 
  • Moderately convex or retrusive mandible or chin are not appropriate patients.

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