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Impact of orthodontic gap closure versus prosthetic replacement of missing maxillary lateral incisor on dental arch relationships and symmetry on 212 cleft patients: a retrospective study Missing lateral incisor gap in cleft patients (39/40 characters max).

BACKGROUND
Maxillary lateral incisors (MLI) are frequently missing in cleft patients. The aim of this study was to assess how orthodontic gap closure or prosthetic rehabilitation of the missing MLI affected the dental arch relationships and symmetry at the end of treatment. We also aimed to determine the impact of the level of oral hygiene on the decision made to manage the missing MLI gap.


METHODS
A descriptive, retrospective cohort study including all cleft patients born between 1980 and 1999 treated at Nantes Cleft Center was performed. Patients presenting unilateral or bilateral missing MLI were reviewed. Data about management of the missing MLI gap, dental arch relationships, symmetry and level of oral hygiene were collected.


RESULTS
Four hundred and eighty-six cleft patients were reviewed, including 212 patients with unilateral or bilateral missing MLI. When compared to orthodontic gap closure, prosthetic replacement of the MLI gap was associated with better final dental arch relationships (59.8% vs. 10.3%; p<0.01) and better dental arch symmetry (88.1% vs. 44.0%; p<0.01) for unilateral missing MLI cases but not for bilateral missing MLI cases. A better level of oral hygiene was associated with more cases with prosthetic replacement for unilateral missing MLI cases (p=0.03) and had no impact for bilateral missing MLI cases.


CONCLUSION
Prosthetic replacement of the missing MLI gap provided better functional and esthetic results for cleft patients presenting with unilateral missing MLI.