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Case Masters

Congenitally Missing Teeth and Generalized Diastemas Treated by Comprehensive Approach

This is a case report by Dr Mehran Bahrami, Fariba Saleh Saber and Amirreza Hendi presenting 2 patients. The first patient was a 23-year-old male with generalized anterior diastemas. Fixed braces were applied for 3 years followed by resin-bonded-fixed-partial-dentures (RBFPDs) in the left premolars’ areas and single-tooth implants in the right premolars’ area. The second patient was a 20-year-old female with congenitally missing upper canines, diastemas in upper anterior teeth and crowding in lower anteriors. Removable orthodontic appliances were used for upper/lower arches. By the end of orthodontic treatment, there was still inadequate space for insertion of regular implant (4mm) and the patient refused to have RBFPDs. So, minimal proximal preparation of the upper laterals and 1st premolars was essential to increase the mesiodistal space. One-piece SDIs, 2x12 mm (SlimLine, Dentium, Korea) implants were used to replace the upper canines.

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Patient 1: Preoperative clinical photo.
Patient 1: Unequal spaces remained around the upper/lower 1st premolars after at the end of orthodontic treatment.
Patient 1: A panoramic X-ray showing no space between the apices of canines and second premolars in upper/lower left side, nut enough space for single-tooth implant in the upper/lower right side.
Patient 1: A 3.4x12 mm fixture was inserted for tooth 15 and a 3.8x12 mm fixture (Implantium, Internal hexagon connection, Dentium, Korea) was inserted for tooth 44.
Patient 1: Intraoral digital impressions and interocclusal record.
Patient 1: RBFPDs were prepared with chamfer finishing lines with 0.5-mm lingual reduction and 1mm supragingivally to allow adequate, enough strength and optimal bonding on enamel.
Patient 2: A clinical photo of the upper arch showing orthodontic removable retainer was used to close the diastema by providing 3 mm spaces in the canine areas.
Patient 2: In the lower arch, tooth 31 was extracted to gain sufficient space to resolve the crowding and fixed retainer was used to avoid relapse.
Patient 2: A panoramic X-ray after 2 years of implants’ placement.
Avatar
Case Masters

Congenitally Missing Teeth and Generalized Diastemas Treated by Comprehensive Approach

This is a case report by Dr Mehran Bahrami, Fariba Saleh Saber and Amirreza Hendi presenting 2 patients. The first patient was a 23-year-old male with generalized anterior diastemas. Fixed braces were applied for 3 years followed by resin-bonded-fixed-partial-dentures (RBFPDs) in the left premolars’ areas and single-tooth implants in the right premolars’ area. The second patient was a 20-year-old female with congenitally missing upper canines, diastemas in upper anterior teeth and crowding in lower anteriors. Removable orthodontic appliances were used for upper/lower arches. By the end of orthodontic treatment, there was still inadequate space for insertion of regular implant (4mm) and the patient refused to have RBFPDs. So, minimal proximal preparation of the upper laterals and 1st premolars was essential to increase the mesiodistal space. One-piece SDIs, 2x12 mm (SlimLine, Dentium, Korea) implants were used to replace the upper canines.

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