Missing maxillary incisors: a comparison between dental implants, orthodontic space closure and tooth autotransplantation.

Dr. Ewa Czochrowska, DDS, PhD.   

Keynote Lecture - Saturday, September 20, 2014

Traumatic loss of a maxillary incisor represents an immediate need for dental rehabilitation. Prosthodontic replacements including dental implants and tooth-supported restorations, orthodontic space closure and autotransplantation of teeth are the available treatment options, which in growing patients must consider the growth adaptation and life-long perspective. Orthodontic space closure and tooth autotransplantation can provide a natural substitution to replace a missing maxillary incisor. However, orthodontic space closure is more common to replace missing maxillary lateral incisors, while autotransplantation of developing premolars is usually applied in growing patients with a missing maxillary central incisor. Comprehensive evaluation of many aspects including type and number of missing teeth, space conditions, availability of donors, occlusion and profile, posttreatment stability and the patient’s expectations is necessary before the treatment. Important aspects of the interdisciplinary treatment planning in patients with missing maxillary incisors will be described during the lecture. Dental implants are successfully applied to replace missing incisors, but they require adequate amount of bone to accommodate the fixture, which in patients with traumatic injuries may be lost during trauma or follow-up. Additional surgical procedures aiming at augmentation of hard and soft tissues might be included to obtain a satisfactory clinical and esthetic result. In contrast to dental implants, orthodontic tooth movement and autotransplantation of developing teeth are able to regenerate the alveolar bone and they have a potential for a successful long-term outcome, which sometimes might be less using dental implants.

During the lecture the comparison between dental implants, orthodontic space closure and tooth autotransplantation will be provided including the description of critical aspects and the long-term outcome. Various clinical applications will be shown to illustrate important details of the described procedures.

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