Hypodontia of maxillary lateral incisors: Open or close the space?

AIM: To assess the influence of skeletal, occlusal, and extraoral factors on the treatment choice for maxillary lateral incisors hypodontia. MATERIALS AND METHODS: The investigation was conducted at the LSMU Orthodontic Clinic using the OnyxCeph system database. A total of 37 patients diagnosed with unilateral or bilateral maxillary lateral incisors hypodontia and undergoing treatment were included in the study. The analysis involved examining lateral cephalograms, digital dental models, and intraoral and extraoral photographs. Statistical analysis was performed using the IBM SPSS software. RESULTS: Orthodontic space opening was performed in 21 patients (56.8%), while space closure was chosen for 16 patients (43.2%). For unilateral hypodontia, space opening was preferred in 70% of patients, whereas cases of bilateral agenesis leaned toward space closure in 58.8% of instances (p>0.05). Space opening was more commonly chosen when the unaffected side of the dental arch exhibited Angle class I or class III molar relationship (84.6% and 100%, respectively). Conversely, cases with Angle class II molar relationship were more frequently managed with space closure (66.7%, p<0.05). For class II canine relationship, space closure was more commonly performed (60%), while space opening was favored for class I or class III (100% and 100% respectively) (p<0.05). A concave facial profile led to the selection of space opening treatment (90%), while a straight profile resulted in space closure treatment (61.5%) (p<0.05). CONCLUSIONS: The choice of treatment method for maxillary lateral incisors hypodontia is influenced by the molar and canine relationships on the unaffected side, as well as the patient’s profi le type.