2. The maxillary lateral incisor is the 2nd most frequently
missing tooth after the mandibular second premolar (not
including the third molars)
20% of all missing teeth are the maxillary lateral
incisors.
Agenesis of both maxillary lateral incisors(bilateral) is
more common then agenesis of only one
(unilateral).(Symons,1991)
Females are more affected then males.(Bergstrom,1977)
3. Agenesis of the maxillary lateral incisor is also linked
with other dental anomalies such as :
1) Agenesis of other permanent teeth.
2) Microdontia of the contra lateral maxillary lateral incisor (Peg-
shaped) and other permanent teeth.
3) Palatally displaced canines.
4) Distal angulation of the mandibular 2nd premolars.
4. Therefore the absence of one or more maxillary lateral
incisor introduces a potential imbalance in the maxillary
dental arch, obvious impact on facial aesthetics and it
requires a complex and multidisciplinary treatment
approach.
5. The 2 major treatment approaches for
congenitally missing lateral incisors are:
1) Space Closure (Canine subistution)
2) Space Opening (To allow prosthodontic
replacement)
6. Several factors need to be considered when deciding whether to
close the space left by a maxillary lateral incisor or to open the
space for a prosthetic tooth:
1) The presence of skeletal malocclusion.
2) Amount of crowding.
3) Facial profile.
4) Canine shape and color.
5) Lip level and gingival contour.