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      Congenitally Missing Maxillary Lateral Incisors: Update on the Functional and Esthetic Parameters of Patients Treated with Implants or Space Closure and Teeth Recontouring

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          Abstract

          Maxillary lateral incisor agenesis (MLIA) is a condition that affects both dental esthetics and function in young patients, and represents an important challenge for clinicians. Although several treatment options are available, the mesial repositioning of the canines followed by teeth recontouring into lateral incisors; or space opening/maintenance followed by implant placement have recently emerged as two important treatment approaches. In this article, the current and latest literature has been reviewed in order to summarize the functional and esthetic outcomes obtained with these two forms of treatment of MLIA patients in recent years. Indications, clinical limitations and the most important parameters to achieve the best possible results with each treatment modality are also discussed. Within the limitations of this review, it is not possible to assert at this point in time that one treatment approach is more advantageous than the other. Long-term followup studies comparing the existing treatment options are still lacking in the literature, and they are necessary to shed some light on the issue. It is possible, however, to state that adequate multidisciplinary diagnosis and planning are imperative to define the treatment option that will provide the best individual results for patients with MLIA.

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          Smile attractiveness. Self-perception and influence on personality.

          To investigate self-perception of smile attractiveness and to determine the role of smile line and other aspects correlated with smile attractiveness and their influence on personality traits. Participants judged their smile attractiveness with a patient-specific questionnaire. The questionnaire contained a spontaneous smiling photograph of the participant. Objective smile-line height was measured using a digital videographic method for smile analysis. Personality was assessed with the Dutch Personality Index. Cronbach's alpha for the smile judgment questionnaire was .77. The results showed that size of teeth, visibility of teeth, and upper lip position were critical factors in self-perception of smile attractiveness (social dimension). Color of teeth and gingival display were critical factors in satisfaction with smile appearance (individual dimension). Participants, smiling with teeth entirely displayed and some gingival display (two to four millimeters), perceived their smile line as most esthetic. Smiles with disproportional gingival display were judged negatively and correlated with the personality characteristics of neuroticism and self-esteem. Visibility and position of teeth correlated with dominance. The results of this research underpin the psychosocial importance and the dental significance of an attractive smile.
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            Dental agenesis: genetic and clinical perspectives.

            Dental agenesis is the most common developmental anomaly in humans and is frequently associated with several other oral abnormalities. Whereas the incidence of missing teeth may vary considerably depending on dentition, gender, and demographic or geographic profiles, distinct patterns of agenesis have been detected in the permanent dentition. These frequently involve the last teeth of a class to develop (I2, P2, M3) suggesting a possible link with evolutionary trends. Hypodontia can either occur as an isolated condition (non-syndromic hypodontia) involving one (80% of cases), a few (less than 10%) or many teeth (less than 1%), or can be associated with a systemic condition or syndrome (syndromic hypodontia), essentially reflecting the genetically and phenotypically heterogeneity of the condition. Based on our present knowledge of genes and transcription factors that are involved in tooth development, it is assumed that different phenotypic forms are caused by different genes involving different interacting molecular pathways, providing an explanation not only for the wide variety in agenesis patterns but also for associations of dental agenesis with other oral anomalies. At present, the list of genes involved in human non-syndromic hypodontia includes not only those encoding a signaling molecule (TGFA) and transcription factors (MSX1 and PAX9) that play critical roles during early craniofacial development, but also genes coding for a protein involved in canonical Wnt signaling (AXIN2), and a transmembrane receptor of fibroblast growth factors (FGFR1). Our objective was to review the current literature on the molecular mechanisms that are responsible for selective dental agenesis in humans and to present a detailed overview of syndromes with hypodontia and their causative genes. These new perspectives and future challenges in the field of identification of possible candidate genes involved in dental agenesis are discussed.
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              Hypodontia in orthodontically treated children.

              The frequency of hypodontia in orthodontically treated children, both male and female, and the association between tooth type, the upper or lower arch, the affected side and Angle's classification were studied using interviews, oral, study cast and panoramic radiographic examinations of 212 patients with a mean age of 12 years 7 months. A hypodontia frequency of 11.3 per cent was found for the total sample. This was higher than the incidence of hypodontia reported in other studies of orthodontically treated children. The most frequently missing teeth were the maxillary lateral incisors, and maxillary and mandibular second premolars. The missing teeth were more often absent on the right (54.2 per cent) than on the left (45.8 per cent) side, in both males and females. One tooth was absent in 29.2 per cent of patients, two in 58.5 per cent, but seldom three or more. Orthodontic space closure was the treatment of choice in 87.5 per cent of the subjects.
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                Author and article information

                Journal
                Open Dent J
                Open Dent J
                TODENTJ
                The Open Dentistry Journal
                Bentham Open
                1874-2106
                6 January 2015
                2014
                : 8
                : 289-294
                Affiliations
                [1 ]Department of Restorative Dentistry, State University of Campinas, Campinas, Brazil
                [2 ]Department of Dentistry, University Center of Maringá - UNICESUMAR, Maringá, Brazil
                [3 ]Department of Dentistry, State University of Maringá, Maringá, Brazil
                Author notes
                [* ]Address correspondence to this author at the Department of Dentistry, State University of Maringá, Av. Mandacaru 1.550, 87080-000 – Maringá, PR, Brazil; Tel: (55) 44 99820215; Fax: (55) 44 30319051; E-mail: renatapascotto@ 123456gmail.com
                Article
                TODENTJ-8-289
                10.2174/1874210601408010289
                4311382
                25646137
                052b92ae-45a2-4320-a45c-b8ea473b6136
                © Pini et al.; Licensee Bentham Open.

                This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                History
                : 25 October 2014
                : 9 December 2014
                : 19 December 2014
                Categories
                Article

                Dentistry
                agenesis,composite resin,dental agenesis,dental implants,maxillary lateral incisors,orthodontic treatment.

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