Prioritäten bei der Behandlung heranwachsender und junger Patienten mit fehlenden oberen Schneidezähnen

Zusammenfassung

Bei heranwachsenden und jungen Patienten mit fehlenden oberen Schneidezähnen sollte der kieferorthopädische Lückenschluss als erste Alternative in Betracht gezogen werden. Der kieferorthopädische Lückenschluss ist eine evidenzbasierte, effektive Behandlungsoption. Wahrscheinlich die beste, wenn das Ziel eine langfristige parodontale Gesundheit ist und die einzige Möglichkeit, die Behandlung im Jugendalter abschließen zu können. Dieser Ansatz ist heute bei allen Fehlstellungen als erster Schritt eines interdisziplinären Ansatzes möglich, der nicht nur auf die Korrektur der Fehlstellung, sondern auch auf die Reduzierung der Invasivität der nachfolgenden restaurativen Behandlung abzielt. Dieser Artikel stellt die Gründe für den Lückenschluss dar und gibt klinische Tipps für die interdisziplinäre Behandlungsplanung und das Finishing.

Abstract

In the growing and young patients with missing upper incisors, orthodontic space closure (SC) should be considered the first alternative. Orthodontic space closure is an evidence-based, effective treatment option: probably the best if the goal is long-term periodontal health and the only way to finish treatment in adolescence.

This approach is now possible in all malocclusions as the first step of an interdisciplinary treatment, which aims not only at the correction of the malocclusion, but also at reducing the invasiveness of the subsequent restorative treatment.

This article presents the rationale for space closure and provides clinical tips for interdisciplinary treatment planning and finishing.

Schlüsselwörter

Schneidezähne - Lückenschluss - parodontale Gesundheit - interdisziplinäre Behandlungsplanung

Keywords

Incisors - orthodontic space closure - periodontal health - interdisciplinary treatment planning

Publication History

Article published online:
17 September 2025

• Literatur

• 1 Nordquist GG, McNeill RW. Orthodontic vs. restorative treatment of the congenitally absent lateral incisor – long term periodontal and occlusal evaluation. J Periodontol 1975; 46: 139-143
• 2 Thordarson A, Zachrisson BU, Mjör IA. Remodeling of canines to the shape of lateral incisors by grinding: a long-term clinical and radiographic evaluation. Am J Orthod Dentofac Orthop 1991; 100: 123-132
• 3 Robertsson S, Mohlin B. The congenitally missing upper lateral incisor. A retrospective study of orthodontic space closure versus restorative treatment. Eur J Orthod 2000; 22: 697-710
• 4 Czochrowska EM, Skaare AB, Stenvik AR. et al. Outcome of orthodontic space closure with a missing maxillary central incisor. Am J Orthod Dentofacial Orthop 2003; 123: 597-603
• 5 Jamilian A, Perillo L, Rosa M. Missing upper incisors: a retrospective study of orthodontic space closure versus implant. Prog Orthod 2015; 16: 2-8
• 6 Rosa M, Lucchi P, Ferrari S. et al. Congenitally missing maxillary lateral incisors: Long-term periodontal and functional evaluation after orthodontic space closure with first premolar intrusion and canine extrusion. Am J Orthod Dentofac Orthod 2016; 149: 339-348
• 7 Josefsson E, Lindsten R. Treatment of missing maxillary lateral incisors: a clinical and aesthetic evaluation. Eur J Orthod 2019; 41: 273-278
• 8 Abduo J, Tennant M. Impact of lateral occlusion schemes: A systematic review. J Prosthet Dent 2015; 114: 193-204
• 9 Rosa M, Zachrisson BU. Integrating esthetic dentistry and space closure in patients with missing maxillary lateral incisors. J Clin Orthod 2001; 35: 221-234
• 10 Rosa M, Zachrisson BU. Integrating space closure and esthetic dentistry in patients with missing maxillary lateral incisors. J Clin Orthod 2007; 41: 563-573
• 11 Rosa M, Zachrisson BU. The space-closure alternative for missing maxillary lateral incisors: an update. J Clin Orthod 2010; 44: 540-549
• 12 Rosa M, Zachrisson BU. Missing maxillary lateral incisors: new procedures and indications for optimal space closure. In: Nanda R (ed). Esthetics and Biomechanics in Orthodontics. 2^nd ed. Elsevier Saunders; St. Louis MO: 2014: 528-559
• 13 Olivadoti A, Doldo T, Treccani M. Morpho-dimensional analysis of the maxillary central incisor clinical crown in cases of congenitally missing upper lateral incisors. Prog Orthod 2009; 10: 12-19
• 14 Yaqoob O, DiBiase AT, Garvey T. et al. Relationship between bilateral congenital absence of maxillary lateral incisors and anterior tooth width. Am J Orthod Dentofacial Orthop 2011; 139: e229-e233
• 15 Mirabella AD, Kokich VG, Rosa M. Analysis of crown widths in subjects with congenitally missing maxillary lateral incisors. Eur J Orthod 2012; 34: 783-787
• 16 Ramazanzadeh BA, Ahari F, Hajian S. Evaluation of tooth size in patients with congenitally-missing teeth. J Dent Res Dent Clin Dent Prospects 2013; 7: 36-41
• 17 Wright J, Bosio JA, Chou JC. et al. Maxillary lateral incisor agenesis and its relationship to overall tooth size. J Prosthetic Dent 2016; 115: 209-214
• 18 Al-Rushaid S, Chandhoke T, Utreja A. et al. Three-dimensional evaluation of root dimensions and alveolar ridge width of maxillary lateral incisors in patients with unilateral agenesis. Prog Orthod 2016; 17: 30
• 19 Mourshed B, Samran A, Alfagih A. et al. Anterior cantilever resin-bonded fixed dental prostheses: a review of the literature. J Prosthodont 2018; 27: 266-275
• 20 Lucchi P, Rosa M. A new method for temporary rehabilitation in growing patients with congenitally missing lateral incisors. Dent Cadmos 2017; 85: 2-6
• 21 Rosa M. Cross-bite correction in mixed mentition: mationale and mlinical recommendations. Semin Orthod 2023; 29: 177-182
• 22 Ludwig B, Zachrisson BU, Rosa M. Non-compliance space closure in patients with missing maxillary lateral incisors. J Clin Orthod 2013; 47: 180-187
• 23 Rosa M. Orthodontic space closure after loss of maxillary incisors and periodontal breakdown of the edentulous area and on adjacent teeth. Semin Orthod 2024; 30: 162-171