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The treatment dilemma of missing maxillary lateral incisors-Part I: Canine substitution and resin-bonded fixed dental prostheses.

OBJECTIVE: Clinicians are faced with three common treatment options for the high frequency of missing or lost maxillary lateral incisors; canine substitution, a resin-bonded fixed dental prosthesis (RBFDP), or a dental implant. A review of current data and guidelines for treatment provide new insight into making the most appropriate selection.

OVERVIEW: The incidence of maxillary incisor agenesis and loss is prevalent. Both canine substitution and RBFDPs exhibit esthetic and functional advantages and disadvantages.

CONCLUSIONS: Most missing lateral incisors are detected at an early age as a result of congenital absence; therefore, proper treatment of these young patients is essential. Both canine substitution and RBFDPs can provide long-term success and esthetics when carefully executed. The decision should be based on the patient's expectations, their clinical presentation, cost, and the team's ability to provide the best long-term esthetic and functional prognosis for a specific patient.

CLINICAL SIGNIFICANCE: Patients regularly present for treatment of missing and lost maxillary lateral incisors. The functional and esthetic aspects of canine substitution and a RBFDP should be clearly understood relative to the clinical parameters of each patient prior to treatment.

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