Missing Lateral Incisor Options — ORE Part 1 MCQ

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ModerateOrthodonticsMissing Lateral Incisor OptionsORE Part 1

A 25-year-old patient has congenitally missing upper lateral incisors bilaterally. The canines have drifted mesially into the lateral incisor positions. What are the two main orthodontic/restorative management options?

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Correct answer: C — Space opening for prosthetic replacement (implants, bridges) OR space closure with canine substitution

The two established main management options for bilateral congenitally missing upper lateral incisors are space opening for prosthetic replacement and space closure with canine substitution. Option C correctly identifies both. Option D is incorrect because extracting functional canines is not standard practice—the canines, though drifted, are natural teeth and should be retained in most cases. Option E (no treatment) is inappropriate given esthetic and occlusal consequences. Option A (veneers without orthodontics) fails to address fundamental space and occlusal issues. Option B (central incisor extraction) is unjustifiably destructive. Orthodontists choose between space opening and closure based on cephalometric relationships, smile esthetics, canine morphology, and patient wishes—not on routine extraction of sound teeth.

Reference: Paduano S, Cioffi I, Rongo R, et al. Orthodontic Management of Congenitally Missing Maxillary Lateral Incisors: A Case Report. Case Rep Dent. 2014. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970084/; Silveira GS, Almeida NV, Pereira DMT, Mattos CT, Mucha JN. Prosthetic replacement vs space closure for maxillary lateral incisor agenesis: A systematic review. Am J Orthod Dentofacial Orthop. 2016;150(2):228-237.