PDF: Management of Hypodontia with canine substitution: A Case Report

The incidence of missing teeth in the oral cavity has been considered as a progressive step in evolution.

According to a theory proposed by Butler known as the Butler Field Hypothesis the most mesial tooth in an arch is the most morphologically stable tooth and the abnormal morphological variation increases progressively to the most distal tooth in the arch.

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This theory was proposed for mammals and was adapted by Dahlberg who applied this principle for human beings and divided the human dental arch into different developmental fields and said that the mesial tooth in each developmental field is the most morphologically stable tooth in the arch.

Management of hypodontia especially involving upper lateral incisors in orthodontic patients can pose a challenge in orthodontic management. Management of cases with missing maxillary lateral incisors has many options which includes the replacement of missing teeth with the help of a prosthesis or implant both of which have their drawbacks According to. Dr. Kokich the most aesthetic and functional treatment option for management of a missing maxillary lateral incisor is canine substitution .

Though the canine can be re shaped to have an aesthetic appearance of a maxillary lateral incisor, sometimes a Crown or a veneer may have to be placed on the substituted canine to improve easthetics.Correction of proclination of the anteriors along with canine substitution would require the protraction of the maxillary posterior segment in cases which exhibit class I molar relationship.