Aesthetic evaluation of the smile in patients with missing maxillary lateral incisors: a review of the literature

Objectives. Our aim was to identify the aesthetic parameters of the smile that should be assessed in patients with missing maxillary lateral incisors, by means of a review of the most recent literature on this topic. Materials and methods. Using the most common search engines, such as Pub Med and the Cochrane library, we selected articles published between 1995 and 2010, which were indexed with the following Keywords "congenitally missing lateral incisors", "aesthetic aspects", "long-term clinical results", "smile arc", and "soft-tissue aspects". Of the 28 articles selected, 10 were eliminated because they had follow ups <5 years or referred to sponsored studies. The remaining 18 articles only 12 articles were analyzed to identify the aesthetic parameters to evaluate in smile assessment of patients with missing maxillary lateral incisors. Results. The review showed that when upper incisors are missing, good aesthetic results can be obtained with the traditional space-opening approach or with orthodontic space closure and mesialization of the lateroposterior sectors. However, clinicians currently prefer the orthodontic space closure option. Conclusions. Treatment options for patients with missing maxillary lateral incisors include either space closure approaches and those based on space reopening and insertion of implants. Both offer good results in terms of smile aesthetics.