Clinical and radiographical evaluation of two agenesis alveolar ridges of upper lateral incisors. A case report with 5 years follow up

Besides the functional issues, lateral incisor agenesis represents a significant aesthetic drawback (1). The decision about the treatment plan is complex due to the long-term success, which is not easy to achieve. It has to be discussed with the orthodontists to choose the closure, using permanent canines to replace the missing teeth, or maintaining the spaces, for example, with Maryland bridges or implants. The main advantage of orthodontic gap closure is that this approach preserves the natural architecture of the complex and soft tissues. However, canines and premolar sizes and shapes should be adjusted to mimic the replaced teeth, eventually resorting to odontoplasty or veneers (13). This article aims to show clinical protocols and procedures for the Split Crest without any graft. The biggest problem in agenesis cases is the thickness of the bone, which is bucco-palatal and associated with the need for proper functional and esthetic rehabilitation. In the case that we reported, because of the lack of thickness, we performed a minimally invasive split crest, which allowed us to correct the implant insertion with immediate loading by a temporary crown, just for aesthetic reasons.