Orthodontic canine substitution vs. implant-supported prosthetic replacement for maxillary permanent lateral incisor agenesis: A systematic review.

OBJECTIVE

The aim of this systematic review was to evaluate the results of two treatment methods: space opening for an implant and prosthetic replacement (PR) versus orthodontic space closure (SC) for maxillary lateral incisor agenesis (MLIA).

MATERIAL AND METHODS

The protocol of the systematic review is in line with the PRISMA requirements. An electronic search was carried out on July 11, 2021 in Pubmed, ScienceDirect, Web of Science, and Plos One databases. The review included research articles published less than 10 years ago, written in English, involving both PR and SC methods in permanent dentition, and comparing and evaluating them.

RESULTS

A total of 1,061 initially identified articles were found, full texts of 38 articles were read and assessed for eligibility, and 7 of them were included in this review. All of the articles evaluated the esthetics; in addition, 3 of them assessed periodontal health, 1 evaluated temporomandibular joint (TMJ) dysfunction, and 1 evaluated occlusion morphology disorders. One study of 7 found esthetics after SC to be statistically more pleasant, while the others found the results of both techniques to be equally esthetically satisfying. When comparing periodontal status between the groups, one study found gingival recession to be significantly more common in the SC group, while another article revealed that gingival recession and papillary defects were more common in the PR group. The remaining articles stated that there was no TMJ dysfunction, and differences in occlusion morphology disorders were not significant between the groups.

CONCLUSION

The results of MLIA treatment with SC were more favorable esthetically, but the difference was not statistically significant. There is no statistically significant data related to periodontal health, and neither of the treatment methods caused TMJ or occlusion morphology disorders. If both methods are available, space closure is preferable, although high-quality clinical trials are needed to find more evidence.