A new approach to treating mandibular premolar bilateral agenesis

Rafael de Faria Bicalho e Jaime Sampaio Bicalho

Introduction: Tooth agenesis is a clinical condition increasingly present in Orthodontics, and second mandibular premolars have the highest incidence of congenital absence, after third molars. Factors such as the condition of the deciduous molar, patient’s age, dental and skeletal relationships, patient’s willingness to undergo extensive dental treatment, quantity and quality of bone support in the affected region and financial considerations must be taken into account when deciding whether to open or close existing spaces. Objective: This article aims at demonstrating a novel approach to close residual spaces in growing patients with Class I malocclusion and mandibular premolar bilateral agenesis. Treatment: Agenesis spaces were closed by means of a simple retraction mechanics with reciprocal anchorage loss. Subsequently, mandibular teeth were proclined using FLF mandibular protraction appliance. Results: By the end of treatment, the patient presented a canine Class I and a molar Class III relationship, coincident dental midlines and correct overjet and overbite. Conclusion: This approach seems to be a viable treatment option for growing patients with mandibuar premolar bilateral agenesis.

Keywords: Anodontia. Corrective Orthodontics. Angle Class I malocclusion. Mandibular advancement.

How to cite: Bicalho RF, Bicalho JS. Uma nova abordagem para o tratamento da agenesia bilateral de pré-molares inferiores. Rev Clín Ortod Dental Press. 2016 Fev-Mar;15(1):39-54.

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