Postorthodontic root approximation after opening space for maxillary lateral incisor implants.
BACKGROUND
Orthodontic space opening during adolescence is a common treatment for congenitally missing maxillary lateral incisors. Because of continued facial growth and compensatory tooth eruption, several years can elapse between completion of orthodontic treatment for a teenage patient and implant placement. There are reports that, after successful orthodontic opening of the implant space, the central incisor and canine roots reapproximate during retention and prevent implant placement.


METHODS
To study this phenomenon, the records of 94 patients with missing maxillary lateral incisors were collected. Periapical and panoramic radiographs were used to measure intercoronal and interradicular distances between the central incisor and the canine adjacent to the missing lateral incisor before and after orthodontic treatment and at implant placement.


RESULTS
Although root approximation between the adjacent central incisor and canine during retention did not occur consistently, 11% of the patients experienced relapse significant enough to prevent implant placement.


CONCLUSIONS
To ensure sufficient space for implant placement, we recommend at least 6.3 mm of intercoronal space and 5.7 mm of interradicular space between the adjacent central incisor and canine. A bonded wire or resin-bonded bridge will help to reduce root approximation that might occur during retention.
Department of Orthodontics, University of Washington, Seattle, WA, USA. TaylorOlsenDDS@gmail.com
Taylor M
TM
Olsen
Vincent G
VG
Kokich
D000293:Adolescent; D000328:Adult; D000848:Anodontia / Q000628:therapy*; D000075202:Contraindications; D003481:Cuspid / Q000000981:diagnostic imaging / Q000254:growth & development; D003758:Dental Implantation, Endosseous / Q000379:methods; D019250:Dental Implants, Single-Tooth; D006801:Humans; D007180:Incisor / Q000002:abnormalities*; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D014078:Tooth Eruption; D014085:Tooth Migration / Q000517:prevention & control*; D014087:Tooth Movement Techniques / Q000592:standards*; D014092:Tooth Root / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D055815:Young Adult