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Abstract
Congenitally Missing Maxillary Lateral Incisors: Space Closure with Aligners and Without Skeletal Anchorage
Management of maxillary lateral incisor agenesis remains one of the most demanding challenges in contemporary orthodontics, requiring an optimal balance between aesthetics, function, and long-term stability. While space opening for prosthetic or implant rehabilitation remains a valuable treatment option, orthodontic space closure through mesial movement of the posterior segments offers a biologically conservative and predictable alternative in carefully selected patients.
The introduction of clear aligner therapy has significantly changed the biomechanical approach to these treatments. Three-dimensional control of tooth movement, accurate digital treatment planning, and the use of intermaxillary elastics now allow clinicians to perform movements that were traditionally considered difficult without routinely relying on skeletal anchorage.
This lecture will present a clinical protocol for treating maxillary lateral incisor agenesis using clear aligners and elastics alone. The presentation will discuss patient selection, digital setup design, dental anchorage management, and biomechanical strategies for controlled space closure. Particular emphasis will be placed on torque control of incisors and canines, midline correction, occlusal finishing, and smile aesthetics, highlighting how the incisal coverage provided by aligners may offer biomechanical advantages over fixed appliances in controlling anterior tooth inclination.
