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Esthetic evaluation of treatment strategies for missing maxillary lateral incisors
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DOI：10.2319/040125-263.1.png)
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Abstract
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Objectives: To evaluate esthetic outcomes of four treatment options for missing maxillary lateral incisors-canine substitution, canine substitution with buildup, resin-bonded fixed dental prostheses (RBFDPs), and dental implant-and to compare with a control group with sound lateral incisors after orthodontic treatment. Materials and Methods: A total of 144 digital intraoral photographs from clinical expert archives was analyzed, including the control group. Esthetic outcomes were assessed using ImageJ software based on the recurring esthetic dental (RED) proportion, vertical position, black triangles, gingival zenith, color, and apparent contact dimension (ACD). Statistical analyses were conducted to identify significant differences among groups. Results: RED proportion was more favorable in both canine substitution groups than with RBFDPs. Vertical position favored RBFDP over canine substitution with buildup. Black triangles were less frequent in both canine substitution and the control group than with RBFDPs. Gingival zenith was less favorable in both canine substitution groups than the control and with RBFDPs. The control group showed best color outcomes, outperforming all treatment groups except for dental implant. ACD central-lateral incisors was better in the canine substitution with buildup and control group than canine substitution without buildup. ACD lateral incisor-canine was superior in both canine substitution and control groups than with RBFDPs and dental implants. Conclusions: No single treatment excelled across all parameters, emphasizing the need for individualized treatment plans based on patient priorities. Collaborative decision-making is crucial for optimizing esthetic outcomes. (Angle Orthod. 2026;96:215-223.)
Keywords:
Esthetic evaluation
Treatment strategies
Missing maxillary lateral incisors
Maxillary lateral incisor
Dental esthetics
Tooth replacement
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