Calabrò PPF1, Caruso Sara2*, Caruso Silvia2, Prata Paolo1 and Gatto Roberto2
1Private Practice in Dentistry, 03100 Frosinone, Italy
2Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
This case report describes a combined multidisciplinary orthodontic-surgical-prosthetic treatment in a growing patient who presented the agenesis of element 1.1. Dental agenesis or hypodontia is one of the most common developmental anomalies of human dentition; its etiology remains unclear, although most cases involve an autosomal dominant genetic inheritance. Cases of agenesis of the permanent maxillary central incisor, however, are very rare, about 0.01%, and in the literature, it is called "solitary median maxillary central incisor", therefore requires correct multidisciplinary planning, and in this work, we will focus on the correct orthodontic-surgical and prosthetic approach. In this case report, our focus will be on the surgical-prosthetic aspect. The patient comes to observation at the age of 10 for problems initially of an orthodontic type and dental malposition. The patient's treatment plan initially involved rapid expansion of the palate, followed by orthodontic therapy for at least two years, planned avulsions of the deciduous teeth, and the placement of a temporary Maryland bridge. The right therapeutic timing was thus expected (to achieve somatic development) before performing the split crest to make up for the lack of bone thickness with contextual insertion of a Sweden & Martina Prama® Implant for resolution of agenesis of 1.1. Thanks to the right orthodontic approach, we were able to obtain the right space not only mesio-distal but also vestibule-oral as being a genetic it was obviously insufficient. For aesthetic reasons, the shape of the contralateral was corrected with a direct composite restoration. The therapeutic approach chosen allowed us to correct the malocclusion by respecting the correct position of the dental elements, to safeguard the spaces in the arch pending complete exchange and to keep the patient's bone intact for the placement of the implants. All this ensuring an excellent aesthetic result and facial and smile symmetry. Interdisciplinary planning combining orthodontics and esthetic dentistry was key in resolving this case.
Calabrò PPF, Caruso S, Caruso S, Prata P, Gatto R. Interdisciplinary Orthodontic-Surgical-Prosthetic Approach in the Treatment of Permanent Central Incisor Agenesis: A Case Report. Clin Surg. 2022; 7: 3492..