Maxillary Lateral Incisor Agenesis Treated With Closing Space: A Clinical Case

A 12 years old patient, female, wanted orthodontic treatment to improving the aesthetics of her smile. Extra-oral examination showed a convex facial profile, balanced facial thirds, nasolabial angle and smile line within the norm. Intraoral examination indicated a bilateral Class II molar and canine relationships; absence of 1.2 and 2.2 teeth; asymmetry of 1.3 and 2.3; crowding; mandibular line shifted to the right. The panoramic radiograph confirmed Maxillary lateral incisors agenesis. The cephalometric analysis indicated a skeletal Class I and alveolar, a hypodivergent pattern and the interincisal angle was decreased. It was a favorable prognosis. The treatment approach was bimaxillary orthodontic fixed appliance, closing space, torque compensation, and canines coronoplasty. There are several factors with influence on therapeutic decision making, including the patient's age, facial profile, smile line, canine characteristics, number of missing teeth, and malocclusion. According to the literature these cases are treated with space closing. Regarding to the hypodivergent facial pattern would be advised to open space, but the convex facial profile, Class II molar and canine, made the space closure a option that doesn't affect the profile; canines although asymmetrical, have shapes and sizes beneficial for coronoplasty. The high smile line is often a problem, but in this case was appropriate and was not a problemAccording to the diferents factors considered, closing space was the best treatment option for this patient, it was a early and definitive resolution for patients with MLIA. And despite the asymmetry of canines, it was achieved a harmonious smile. Keywords: Maxillary lateral incisor genesis, asymmetry canines, orthodontic close spaces, MLIA