Techniques for improving orthodontic results in the treatment of missing maxillary lateral incisors. A case report with literature review.

We have presented a case report of the orthodontic treatment of a patient with congenitally missing lateral incisors and with skeletal and dental deep bite. Information was provided on methods to improve clinical orthodontic results. Different sections deal with (1) various diagnostic criteria for the best treatment approach, (2) variations in maxillary arch wire manipulation, (3) biomechanical considerations, (4) modifications of clinical crown by special procedures so that the canines resemble and function as lateral incisors, (5) functional considerations of the occlusion, and (6) details in finishing. Particular emphasis was placed on the use of a special design of closing loops for simultaneous space closure and intrusion of the anterior teeth. This article has discussed the principles of incisor and canine intrusion, and has demonstrated that the closing loops described are capable of intruding incisors with minimal side effects on the posterior teeth. It has also demonstrated how control of the mechanical variables dramatically increased the efficiency and effectiveness of intra- and extraoral forces in the treatment of malocclusion.