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Consultant in Orthodontics, University of Manchester Dental Hospital, Higher Cambridge Street, Manchester, M15 6FH, Salford Royal NHS Foundation Trust, Stott Lane, Manchester and Northenden House Orthodontics, Sale Road, Manchester, M23 0DF
Establishing optimal aesthetics, function and periodontal health in patients with missing teeth is a complex and challenging process, which demands the interaction of several dental specialties for effective multidisciplinary management. The most frequent scenario encountered within the orthodontic-restorative interface is missing teeth; this article focuses on the management of missing teeth, discussing diagnosis, the treatment planning process, treatment outcome and retention. This is demonstrated throughout a series of clinical cases treated within a multidisciplinary team.
CPD/Clinical Relevance: The management of patients with missing teeth is often challenging; with a variety of orthodontic and restorative treatment options for the general practitioner.
Article
There are many clinical scenarios where interdisciplinary management is indicated in order to achieve optimal functional and aesthetic treatment outcomes for the patient. This second part of this four-part series will highlight the most frequent scenario encountered within the orthodontic-restorative interface, which is missing teeth.
Spaces in the dentition may arise for various reasons including: removal due to caries or trauma; they may be unerupted (due to supernumeraries or dilacerations), or be congenitally absent. Hypodontia is defined as the congenital absence of one to six teeth, excluding third molars.1 It can be non-syndromic or familial hypodontia, which occurs as an isolated trait, or syndromic hypodontia which occurs with accompanying genetic disease.1 The most commonly missing teeth after third molars (25–35%) are mandibular second premolars (2.8%) and maxillary lateral incisors.2
Patients with absent teeth frequently present with aesthetic and functional problems, which may affect their quality of life, self-esteem and social relationships.3,4 The management of space arising from missing teeth in order to restore a balanced dentition is an area that is best managed as part of a multidisciplinary team.
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