Introduction: The absence of maxillary lateral incisors caused by traumatic or genetic reasons or as a result of endodontic failure is a difficult problem for an implantologist. The difficulties are the result of bone deficiency in all three dimensions, irregularity of interdental papillae locations and often convergence of roots of the neighbouring teeth. The aim of this study was to present the complexity of orthodontic and implant-prosthetic treatment of the absence of maxillary lateral incisors.
Material and methods: Between 2003 and 2007, 11 patients with absence of maxillary lateral incisors were treated in the Department of Oral Surgery of the Pomeranian Medical University in Szczecin. In 5 cases the incisors were congenitally absent, 2 patients lost their incisors because of traumatic injuries and in 4 patients the absence was a result of treatment failures (perforations, fractures, endodontic failures). The average age of the patients was 27 years. The purpose of the initial, orthodontic part of the treatment was to obtain enough space for implantation. During the next part implants were placed in the bone. 15 Zimmer-Dental and Alfa-Bio implants were placed altogether (3.3 and 3.7 mm diameter, 13-16 mm length). Due to bone deficiency, in 11 cases alveolar distraction was necessary and in the rest of the cases bone substitute materials were used to obtain enough amount of bone. Only in 2 patients the implants were loaded immediately, the remaining received prosthetic reconstruction after 6 months; 1 implant was lost (6% of all placed implants).
Conclusions: Implant-prosthetic treatment of single front tooth absence needs cooperation of multiple dental specialties. Implantation with the help of the described alveolar distraction technique seems to be a promising way of reconstruction in cases of bone deficiency.