congenitally missing lateral incisors /underbite

Discussion in 'Dental Archive' started by Straight Teeth, Nov 9, 2004.

  1. I am missing 2 upper lateral incisors congenitally. When I try to
    bite, my front teeth can meet, but back teeth can not. So I have to
    jut my bottom teeth out to bite down. In this way, all my back teeth
    meet okay, but bottom front teeth are in front of the top front teeth.
    So the underbite. There are no spaces between the teeth.
    Most ortho suggest to open up spaces for lateral incisors by push top
    centrals forward. How easy/difficult to open up spaces?
    If we don't open up spaces, just use the cannies as lateral incisors,
    is it possible?
    Straight Teeth, Nov 9, 2004
    #1
  2. Straight Teeth

    carabelli Guest

    "Straight Teeth" <> wrote in message
    news:...
    There are multiple ways to treat this situation dependant on a variety of
    factors. It's difficult to say without an exam and beginning ortho records.
    Even then you probably would get a number treatment plans if you went
    somewhere else for a 2nd, 3rd etc., opinion. Differing ortho treatment
    plans do not necessarily mean only one is the correct one.

    carabelli
    carabelli, Nov 9, 2004
    #2
  3. Ideally, an orthodontist or equivalent trained general dentist can perform
    comprehensive orthodontic treatment to spread your upper teeth out - you
    make it sound as if there's not enough of room, ideally, your bottom front
    teeth should rest behind your upper front ones.

    This sounds complicated, with no easy alternative, except for no treatment.

    --
    Shad Lewis
    www.WyomissingSmiles.com


    "Straight Teeth" <> wrote in message
    news:...
    Shad J. Lewis, DMD, MA, Nov 9, 2004
    #3
  4. Straight Teeth

    carabelli Guest

    "Shad J. Lewis, DMD, MA" <> wrote in message
    news:p...
    treatment.
    What is the equivalent of a 3 year residency?

    carabelli
    carabelli, Nov 9, 2004
    #4
  5. Straight Teeth

    W_B Guest

    On 9 Nov 2004 05:53:22 -0800, (Straight Teeth) wrote:
    Possible but never looks quite right IME.
    --

    W_B

    Take out the G'RBAGE
    W_B, Nov 9, 2004
    #5
  6. Straight Teeth

    W_B Guest

    On 09 Nov 2004 15:46:07 GMT, (Advocate147) wrote:
    When betting Mancuso I don't have to pay the vig.
    --

    W_B

    Take out the G'RBAGE
    W_B, Nov 9, 2004
    #6
  7. "Shad J. Lewis, DMD, MA" <> wrote in message news:<>...
    What are the possible options, pros and cons for each option:
    1. Since i have no spaces anywhere (even without spaces between the
    upper centrals & canines), one option is: don't open spaces for
    laterals, use canines as laterals(my canines are small, easy to
    reshape). Advance upper front teeth forward, move lower front teeth
    inward... I am not sure how much spaces be can created by advance
    upper front teeth? that has to been closed somehow.
    2. 2nd option: most ortho will do in this way. open up spaces for
    laterals ..... I don't know how difficult it is to open up spaces for
    2 teeth. This must need a lot of movement of all upper teeth?
    3. 3rd option: remove lower front teeth since they are too long,
    replace them by small fake teeth, so the bite can easily correct.

    Please let me know your opinions. Thanks!
    Straight Teeth, Nov 9, 2004
    #7
  8. Straight Teeth

    Roy Brown Guest

    I recall someone saying that if you strip 1/2 mm from each side of the lower
    anteriors you can pick up 6 mm.

    Stripping the lower anteriors and pulling them back might allow for a normal
    overbite/overjet relationship. The patients concerns were related to
    occlusion not esthetics.

    or possibly a combination of both
    --
    Roy
    DotSeaEh is .ca

    "W_B" <> wrote in message
    news:...
    | On 9 Nov 2004 05:53:22 -0800, (Straight Teeth)
    wrote:
    |
    | >If we don't open up spaces, just use the cannies as lateral incisors,
    | >is it possible?
    |
    | Possible but never looks quite right IME.
    | --
    |
    | W_B
    |
    | Take out the G'RBAGE
    |
    Roy Brown, Nov 9, 2004
    #8
  9. "Roy Brown" <> wrote in message news:<UJ9kd.20365$>...
    Do you mean that if the lower anteriors are "slendered" 1/2 mm on each
    side, it is like pick up 6 mm on the upper?
    I read that for missing upper laterals, if we want to open up spaces,
    10 mm of inciso-gingival bone is needed, 6 mm of facial-lingal bone is
    needed, right?

    So opening up spaces for laterals is more difficult, but will look
    better.
    Use canines as laterals, and stripping lower anteriors is easier, but
    not look very good. Am I right?
    Straight Teeth, Nov 10, 2004
    #9
  10. Straight Teeth

    carabelli Guest

    "Straight Teeth" <> wrote in message
    news:...

    Roy-

    It depends.

    I would guess - not Evidenced Based Dentistry (just what I've seen - need to
    check the lit again on that) - that many adults with congenitally missing
    upper laterals and upper cuspids, that erupt uneventfully into the lateral
    space end up with a horizontal skeletal discrepany between the maxilla and
    mandible (I could elaborate, but this run on sentence is long enough).

    The thesis would be that the anterior maxilla doesn't grow as much when the
    stimulus of developing lateral incisors is absent.

    As far as treating this particular case - who knows without an exam and
    records. But there are a whole lot of ways to skin a cat, and a whole lot
    of ways to screw it up.

    Dan -- Bob's 47 is in KC again for a short while!!
    carabelli, Nov 10, 2004
    #10
  11. Straight Teeth

    StovePipe Guest

    Straight Teeth <> wrote:
    One thing you haven't mentioned, but could also be considered is
    orthognathic surgery combined with orthodontics. You could have one or
    the other arcade moved partially or totally to make a better
    approximation of tooth contact. The whole thing would then be fine tuned
    by orthodontics, before, after or both.

    Can you get to a schood of Dentistry that teaches Orthodontics as a
    graduate course?
    Just a suggestion
    SP
    --
    Not a real Addy, yet
    StovePipe, Nov 10, 2004
    #11
  12. Straight Teeth

    Roy Brown Guest

    "carabelli" <> wrote in message
    news:9Lgkd.874351$...

    | > "Roy Brown" <> wrote in message
    |
    | >> Stripping the lower anteriors and pulling them back might allow for a
    | >> normal
    | >> overbite/overjet relationship. The patients concerns were related to
    | >> occlusion not esthetics.
    | >>
    | >> or possibly a combination of both
    | >> --
    | >> Roy
    | >> DotSeaEh is .ca
    | >
    | >|
    | Roy-
    |
    | It depends.
    |
    | I would guess - not Evidenced Based Dentistry (just what I've seen - need
    to
    | check the lit again on that) - that many adults with congenitally missing
    | upper laterals and upper cuspids, that erupt uneventfully into the lateral
    | space end up with a horizontal skeletal discrepany between the maxilla and
    | mandible (I could elaborate, but this run on sentence is long enough).
    |
    | The thesis would be that the anterior maxilla doesn't grow as much when
    the
    | stimulus of developing lateral incisors is absent.
    |
    | As far as treating this particular case - who knows without an exam and
    | records. But there are a whole lot of ways to skin a cat, and a whole lot
    | of ways to screw it up.
    |
    | Dan -- Bob's 47 is in KC again for a short while!!
    |
    |

    Dan,

    The "horizontal skeletal discrepany" explains it all to me.
    Thanks
    --
    Roy
    DotSeaEh is .ca
    Roy Brown, Nov 10, 2004
    #12
  13. Straight Teeth

    Roy Brown Guest

    Straight Teeth ,

    Comments in text

    "Straight Teeth" <> wrote in message
    news:...
    | "Roy Brown" <> wrote in message
    news:<UJ9kd.20365$>...
    | > I recall someone saying that if you strip 1/2 mm from each side of the
    lower
    | > anteriors you can pick up 6 mm.
    | >
    | > Stripping the lower anteriors and pulling them back might allow for a
    normal
    | > overbite/overjet relationship. The patients concerns were related to
    | > occlusion not esthetics.
    | >
    | > or possibly a combination of both
    | > --
    | > Roy
    | > DotSeaEh is .ca
    |
    | Do you mean that if the lower anteriors are "slendered" 1/2 mm on each
    | side, it is like pick up 6 mm on the upper?

    It is similar in effect to creating 6 mm of spaces on the upper. Remember we
    are speaking about altering the length of a curve, which is like talking
    about changing the circumference of a circle. Not the overbite/overjet
    relationship which would be analagous to changing the radius of a the
    circle.
    (assuming your front teeth formed a perfect 1/2 circle) Been a while since
    I've touched the math kind of calculus, but I'm sure someone can come up
    with the right function for this.

    | I read that for missing upper laterals, if we want to open up spaces,
    | 10 mm of inciso-gingival bone is needed, 6 mm of facial-lingal bone is
    | needed, right?

    I'm not sure what you are talking about. All I know is that if you add bone
    in the directions you suggest, the bone will essentially replace the current
    position of the teeth. Where are the teeth going to be then?

    |
    | So opening up spaces for laterals is more difficult, but will look
    | better.
    | Use canines as laterals, and stripping lower anteriors is easier, but
    | not look very good. Am I right?

    The ease of the procedure and the relative success of final results is based
    on what you present. Carabelli has touched on that already, and is much more
    knowledgeable in ortho than I.

    --
    Roy
    DotSeaEh is .ca
    Roy Brown, Nov 10, 2004
    #13
  14. Straight Teeth

    StovePipe Guest

    carabelli <> wrote:
    Again: this would tend to suggest the need for surgery here, would it
    not? Move the anterior segment of the MX forward, at least, and perhaps
    move the anterior segment of the MN back with removal of one PM on each
    side. Then Roy's idea would really do something. You could end up with
    alot of space to work with to get a good anterior guidance. I'd think
    you'd have to erupt the posterior segments to get a good occlusion there
    as well.

    This all is just whistlin' in the wind.

    Perhaps the Original Poster could get photos of his models and post
    them.

    Just some ideas
    SP

    Thanks
    SP
    --
    Not a real Addy, yet
    StovePipe, Nov 10, 2004
    #14
  15. > | > "Roy Brown" <> wrote in message
    The most concern is on occlusion, to correct the underbite problem
    because the underbite will affect the esthetics 100%.
    Straight Teeth, Nov 10, 2004
    #15

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