Canine substitution of a missing maxillary lateral incisor in an orthodontic re-treatment case: long term follow up

Introduction: This case report describes the orthodontic re-treatment of a case with a severely compromised maxillary lateral incisor requiring removal and canine substitution. The treatment included creative asymmetric treatment mechanics and a careful management of anchorage. Case Presentation: Pre-treatment, post treatment and 5 years follow-up records are shown. The treatment outcomes proved to be stable at the follow-up with acceptable aesthetic and functional results. Conclusion: Through careful management of anchorage it was possible to successfully use asymmetric treatment mechanics to achieve a good functional occlusion. Submitted: October 16, 2016; Revised: January 29, 2017; Published: April 14, 2017 Lupini D, Lempert S, Cozzani M. Canine substitution of a missing maxillary lateral incisor in an orthodontic re-treatment case: long term follow up. South Eur J Orthod Dentofac Res. 2017;(4)1:14-19. South Eur J Orthod Dentofac Res Lupini D. et al. Missing maxillary lateral incisor 15 The clinical presentation of a patient missing one or both maxillary lateral incisors can vary and through careful planning and ingenuity the orthodontist can develop a plan that takes into account the patient’s unique findings. With multiple treatment options available it is best to have the patient’s pre-treatment expectations aligned with the doctor’s treatment goals to provide the best opportunity for patient satisfaction. The following case report shows the creative management of a severely compromised maxillary lateral incisor that had been subject to failed prior treatment attempts. Literature reports many cases of canine substitution of missing lateral incisor, but very few reports are associated with severe root resorption conditions. 8,9 Ultimately, this tooth required removal and canine substitution. Through asymmetric treatment mechanics it was possible to achieve a pleasing, functional smile and a satisfied patient.