Dr. Eva Lauridsen & Prof. Lars Andersson are welcoming the participants. Honouring Dr. Jens Ove Andreasen.

Orthodontic Space Closure & Orthodontic Prosthetic Solutions

Missing teeth in the esthetic zone can be due to agenesis, impaction, malformation and trauma. The decision whether to close or to open the respective spaces should be made on a very individual basis as many parameters including age, facial esthetics, skeletal relationships, dental proportions, gum exposure, periodontal phenotype, longterm maintenance and lastly economic aspects have tob e considered. While space closure is the preferred option for the sake predictable longterm periodontal health, certain malocclusions and dentofacial patterns cannot be treated by orthodontic space closure, if good interincisal and intercanine contact and lip support are among the primary treatment objectives. Several examplary clinical patients will be presented to illustrate when space closure might not be the best treatment option, but either a cantilever resin-bonded bridge or a single tooth-implant is indicated.

Orthodontic Space Closure & Orthodontic Prosthetic Solutions

The closure of an edentulous space by the orthodontic movement of the adjacent teeth is a treatmentoption nowadays supplanted by the implant-born crown substitution and periodontal regenerative/reconstructive therapy. Nevertheless the orthodontic space closure represents a valuablealternative in many malocclusions complicated by lost maxillary incisors and periodontal breakdown:first of all in the growing patients and when the gingival margins are visible during speechand smile. The lecture will outline crucial details about the orthodontic management of the intact and reducedperiodontal tissues in the pressure area.

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Tooth Replacement in The Anterior Maxilla

Resin-bonded fixed dental prostheses (RBFDPs) with two metal retainer wings have been introduced 40 years ago for a minimal invasive replacement of missing teeth. However due to various reasons metal-ceramic, RBFDPs are not considered a comparable treatment modality to implants by most dentists. Cantilevered anterior RBFDPs with a single ceramic retainer wing were introduced 25 years ago. They provide better esthetics and are less invasive than two-retainer RBFDPs. In the meantime excellent long-term data with bonded zirconia restorations for this minimal invasive treatment option are available. This lecture summarizes when anterior zirconia ceramic RBFDPs present a favorable, minimally invasive and less costly treatment alternative to single tooth implants especially in the anterior maxilla.

Networking

Tooth Replacement in The Anterior Maxilla

Implant treatment in the anterior maxilla is often indicated in patients with congenitally missing lateral incisors and in patients with tooth loss after severe traumatic dental injuries. Both groups of patients are characterized by a young age, which makes planning of implant therapy additionally challenging. Implants cannot be placed in growing individuals, and there is a need for treatment protocols with predictable good long-term prognoses. The presentation will focus on treatment planning in young individuals including timing of implant placement, need for adjunctive procedures such as preprosthetic orthodontics and augmentation procedures of the hard and soft tissues. In addition, the available data on long-term prognosis of dental implants in the anterior maxilla will be presented.

Tooth Replacement in The Anterior Maxilla

Autogenous tooth transplantation has been a treatment option to replace teeth since the 1950’s. The advantage of using the patient's own tissue and the potential of the periodontal ligament to induce development of hard and soft tissues have been studied extensively. The research presented in the studies of Barendregt et al. 2023 and Louropoulou et al. 2024, based on large numbers of transplanted premolars, shows the high predictability of tooth transplantation with the main advantage of transplanted teeth being adaptation to skeletal growth over time. An important finding is that transplantation is no longer restricted to children with donor teeth with open apices. Both publications show that transplanting teeth with closed apices can be as successful and predictable as transplantation of teeth with open apices In our lecture we will focus on indication of the type of teeth used in the anterior region and the factors that influence success. Next to a well-performed surgery, important factors are a good endodontic, periodontal and orthodontic pre-operative preparation as well as a well-structured post-operative follow-up and timely orthodontic/functional loading. This to ensure a minimal complication rate and higher predictability of the treatment outcome. Well applied autotransplants is nowadays a very predictable treatment option in terms function and aesthetics in both children and young adults.

Networking

Tooth Replacement in The Anterior Maxilla

Single or multiple tooth loss in the anterior maxilla is often associated with loss of supporting tissues. In order to maximize the treatment planning and outcome it is essential to have a thorough understanding of the underlying biology associated with tissue loss which will be addressed during the presentation. Furthermore, the use of guided bone regeneration (GBR) techniques in both in moderate as well as severe cases will be discussed with regard to surgical approaches and choice of suitable materials. The presentation will also address how to minimize complications. Finally, long-term data will be presented.

Dialogue