Prosthetic Management of Maxillary Lateral Incisor Agenesis following Orthodontic Space Opening: A Systematic Review of Clinical Evidence

Abstract

Aims: To systematically evaluate the clinical outcomes, esthetic results, and patient satisfaction concerning prosthetic rehabilitation approaches (implant-supported crowns and fixed dental prostheses) following orthodontic space opening in patients with maxillary lateral incisor agenesis. Materials and Methods: A systematic review following PRISMA guidelines was conducted. Electronic databases (PubMed, Scopus, Web of Science, Google Scholar, Cochrane Library) were searched from 2012 to 2024. The risk of bias was assessed using the ROBINS-I and the Newcastle-Ottawa Scale. Results: Out of 379 initially identified publications, 7 studies met the inclusion criteria. The data indicate implants demonstrate superior survival rates (95-100%) compared to bridges (75-90%), particularly resin-bonded bridges. Both modalities showed comparable esthetic outcomes, with high patient satisfaction rates (85-95%). However, space closure with canine camouflage demonstrated better overall esthetic and periodontal outcomes compared to prosthetic replacement. Conclusions: Although implants and bridges are viable options, space closure with canine camouflage is the preferred treatment when feasible. The choice between prosthetic modalities should be individualized based on patient factors, bone availability, and long- term maintenance considerations. High-quality comparative studies with extended follow-up are needed.