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As “leader” of the IDT (Interdisciplinary Dentofacial Team), orthodontists have a responsibility to put forward options for our patients. Ultimately, the family of a child with congenital absence will need to agree to a treatment plan—space opening & implant or space closure & substitution. The discourse regarding implants has evolved from having enough space for a successful result to avoiding “purple roots”, to periimplantitis and on to considerations about the long-term immune system response. In the meantime, the Zachrisson method of correcting agenesis of maxillary lateral incisors and the vander Linden approach to congenital absence of lower second premolars (Hemisection) have enabled results that are much less costly to the family. These are truly lifetime corrections that can be finished within the typical duration of an orthodontic treatment regimen, and results that are superior to implants.
Learning Objectives:
Close space with positive periodontal response and fullness of facial profile.
Effectively avoid the use of implants.
Predictably deliver teeth into their proper locations.
