Missing maxillary laterals are present in about 5% of our population. Most commonly such spaces are closed by dental implants or bonded cantilever bridges. Alternatively tooth transplantations or orthodontic space closure could be an option. In principal mesial space closure is an attractive method for resolving malocclusions associated with agenesis of the maxillary lateral incisors, because it avoids prosthetic implants, which could be aesthetically beneficial in e.g. “Gummy-Smile” patients.  It is possible to treat patients with missing maxillary lateral incisor(s) to a result that provides the look of a healthy, natural dentition by using carefully performed orthodontic space closure perfected with cosmetic restoration of several teeth with porcelain veneers. However, without miniscrew support such treatments may be time-consuming and require good compliance by the patient. This is particularly true for lateral incisor agenesis in Class III malocclusions in cases with narrow maxilla and pronounced spacing. However, with the use of the palatal miniscrew support, what was previously considered difficult or impossible-to-treat cases can now be treated successfully within short treatment durations, since many teeth can be moved mesially at the same time. By integrating such space closure with aesthetic dentistry, an attractive display of the anterior dentition is obtainable in patients with uni-or bilateral agenesis of maxillary lateral incisor(s) and concomitant malocclusions, even in cases which previously was difficult or impossible to treat.

1. What are typical indications for orthodontic space closure?

2. What is the most efficient anchorage for orthodontic space closure?

3. What are orthodontic key factors during orthodontics finishing to enable acceptable aesthetic restorations?