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Absent Lateral Incisor Management — NDEB AFK MCQ

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HardOrthodonticsAbsent Lateral Incisor ManagementNDEB AFK

A 14-year-old presents with bilateral absence of maxillary lateral incisors. Mixed dentition analysis confirms adequate arch length. Which is the most appropriate definitive treatment plan?

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Correct answer: B — Open the lateral incisor spaces orthodontically and restore with implant-supported crowns after growth completion

For bilaterally absent maxillary lateral incisors, the two main treatment options are (1) space opening with implant replacement or (2) space closure with canine substitution. Space opening is generally preferred when the canines are large, the profile is flat (closure would retract the upper lip further), and the overjet is adequate. However, implants cannot be placed until skeletal growth is complete (typically age 18+ for females, 20+ for males). Orthodontic space opening is maintained with a bonded retainer or temporary prosthesis until implant placement.

Reference: Proffit – Contemporary Orthodontics, 6th ed., 2019