Interdisciplinary Management of One or Two Missing Maxillary Incisors: A Clinical Case Series

International Journal of Biomedicine 15(4) (2025) 759-762 http://dx.doi.org/10.21103/Article15(4)_CR2 CASE REPORT INTERNATIONAL JOURNAL OF BIOMEDICINE Interdisciplinary Management of One or Two Missing Maxillary Incisors: A Clinical Case Series Miranda Sejdiu Abazi¹, Arben Abazi2*, Agim Prokshaj1, Tetore Olloni3, Egzon Veliu2 Department of Dentistry, Faculty of Dentistry, UBT College, Pristina, Kosovo Department of Dentistry, Faculty of Medicine, University of Pristina, Pristina, Kosovo 3 Department of Prosthodontics, Faculty of Dentistry, “Hasan Prishtina” University, Prishtina, Kosovo 1 2 Abstract Congenital absence of one or both maxillary lateral incisors is a common dental anomaly that significantly impacts a patient’s facial aesthetics, oral function, and occlusal development. Given the anterior location of these teeth, their absence necessitates careful, individualized treatment planning. The choice between orthodontic space closure and prosthetic replacement depends on a range of dental, skeletal, and aesthetic factors. Therefore, an interdisciplinary approach—typically involving orthodontists, prosthodontists, and occasionally oral surgeons—is essential to achieve optimal functional and aesthetic results. This article presents clinical outcomes from a case series involving patients with one or two missing maxillary lateral incisors. Each case was managed through customized treatment plans based on the patient’s age, occlusal relationship, space conditions, and aesthetic considerations. Treatment modalities included either orthodontic space closure or space opening, followed by prosthetic rehabilitation using supported crowns or resin-bonded prostheses. Diagnostic records, treatment duration, aesthetic results, and patient satisfaction were evaluated. The management of missing maxillary lateral incisors requires a personalized approach that considers the clinical, aesthetic, and psychosocial aspects of each case. No universal solution exists; thus, decisions between space closure and prosthetic replacement should be made collaboratively through interdisciplinary planning. The presented cases highlight that individualized orthodontic-prosthetic strategies can yield excellent functional and aesthetic outcomes.(International Journal of Biomedicine. 2025;15(4):759-762.) Keywords: maxillary incisor • space management • orthodontic space • interdisciplinary treatment For citation:Abazi MS, Abazi A, Prokshaj A, Olloni T, Veliu E. Interdisciplinary Management of One or Two Missing Maxillary Incisors: A Clinical Case Series. International Journal of Biomedicine. 2025;15(4):759-762. doi:10.21103/Article15(4)_CR2 Introduction Maxillary lateral incisor agenesis is one of the most prevalent forms of congenital tooth absence in the anterior maxilla, accounting for approximately 20% of all dental anomalies.1 Overall, dental agenesis affects around 4.2% of the population and represents a significant developmental condition in the permanent dentition.2 The absence of maxillary lateral incisors presents both aesthetic and functional challenges, particularly due to their prominent position in the smile zone. As a result, treatment planning must be highly individualized, considering each patient’s clinical characteristics, occlusal relationship, aesthetic *Corresponding author: Dr. Arben Abazi. E-mail: arbenabazi033@ gmail.com expectations, and psychological profile. There is no universally ideal solution; thus, treatment modalities should be selected based on case-specific functional, periodontal, and aesthetic parameters, with a strong emphasis on long-term success.3 A retrospective study by Robertsson and Mohlin compared two primary treatment strategies for managing maxillary lateral incisor agenesis: orthodontic space closure using canine substitution and space opening followed by prosthetic rehabilitation. Their results indicated higher patient satisfaction and superior periodontal health in the group treated with space closure.4 Spear et al.5 emphasized that the successful management of anterior aesthetics should be guided by aesthetic principles and executed through interdisciplinary collaboration. Treatment should begin with a comprehensive aesthetic analysis and incorporate considerations of function, structure, and biological 760 M. S. Abazi et al. / International Journal of Biomedicine 15(4) (2025) 759-762 health, requiring coordinated efforts among orthodontists, prosthodontists, periodontists, and oral surgeons. Maxillary lateral incisor agenesis is often not an isolated anomaly. It frequently coexists with other dental irregularities, including microdontia of the lateral incisors, agenesis of other permanent teeth, ectopic eruption of maxillary canines, and distoangulation of mandibular second premolars.6 These associated anomalies complicate diagnosis and must be carefully considered during both orthodontic and prosthetic treatment planning. Furthermore, as highlighted by Kavadia et al.,7 current evidence is insufficient to definitively endorse one treatment modality over another for maxillary lateral incisor agenesis. Therefore, a multidisciplinary diagnostic approach and individualized treatment-planning process are essential for selecting the most appropriate therapeutic strategy for each patient. This study is a retrospective clinical case series aimed at evaluating treatment options for patients presenting with the congenital absence of one or two maxillary incisors. All patients were managed using a combination of orthodontic and prosthetic interventions. A total of four patients were included; all treated at the Panacea Clinic in Ferizaj. The sample consisted of two female patients aged 15 and 19 years, and two male patients aged 17 and 23. Inclusion criteria were congenital absence of one or two maxillary incisors and availability of complete diagnostic documentation, including radiographs and clinical photographs. The study adhered to the ethical principles outlined in the Declaration of Helsinki. All patients provided informed consent for participation in this study and the use of their clinical data. Each case was evaluated individually, and treatment was planned through interdisciplinary collaboration involving orthodontists and prosthodontists. The therapeutic approach— either space closure with canine substitution or space opening for prosthetic replacement—was selected based on the specific clinical, aesthetic, and functional needs of each patient. This study presents four clinical cases treated at our clinic, involving patients with congenital absence of one or two maxillary incisors. Each patient underwent a comprehensive clinical, radiographic, and aesthetic evaluation. The therapeutic approach varied from orthodontic space closure with aesthetic reshaping of the canines to space opening followed by prosthetic rehabilitation, depending on the individual needs of each case. Treatment was planned in close collaboration between the orthodon (...truncated)