Treatment of Congenitally Missing Lateral Incisors with Resin-Bonded Fixed Partial Dentures

issing lateral incisors is one of the most common congenital dental anomalies.1–4 New technology and materials offer a wide variety of treatment options for the replace-ment of missing teeth in order to improve esthet-ics and restore function.5 Nevertheless, indications and limitations of each system have to be consid-ered and weighed in each case for the selection of the most adequate treatment. This article presents clinical steps and labora-tory procedures for the treatment of congenitally missing lateral incisors with resin-bonded fixed partial dentures, a traditional approach that is conservative and can provide excellent esthetics if certain guidelines are followed. An innovative ap-proach used to handle the gingival issues and to achieve a natural appearance at the periorestora-tive interface is also presented. TREATMENT PLANNING Patients who are missing a lateral incisor often have a removable appliance to replace the miss-ing tooth, at least for a while following orthodon-tic treatment. Besides orthodontic space closure,6 there are several definitive fixed treatment options for missing lateral incisors: 1. Dental implant and fixed restoration 2. Full-coverage fixed partial denture (porcelain-fused-to-metal [PFM], all-ceramic, or resin-based) 3. Partial-coverage fixed partial denture (metal framework [Maryland bridge], ceramic frame-work, or fiber-reinforced resin with porcelain veneer[s]) Each of these options has advantages and dis-advantages. Implants may eventually be the rou-tine treatment of choice7–9; however, a number of contraindications must be considered: • Medical contraindications • Young age (growth incomplete