![]() ![]() The referring general dental practitioner has a key role in recognizing that this approach may be required and highlighting this in the initial patient referral. Variations in tooth number and tooth size discrepancy often require a combined treatment planning approach from the orthodontist and restorative dentist. The importance of the aesthetic assessment for these cases will be highlighted. In particular, it will concentrate on the assessment of patients who have hypodontia and tooth size discrepancies. The first article in this series of two aims to outline the assessment of patients for whom a combined orthodontic-restorative approach would be beneficial. Great improvements in aesthetics and function may be obtained using an interdisciplinary approach for patients who have variations in tooth number and shape. The orthodontist and restorative dentist are likely to liaise with the patient's general dental practitioner so that he/she can provide the restorative treatment in some cases. Treatment planning in isolation may lead to care being delivered which is below the optimum standard which can be achieved. It is important that both disciplines are involved in the assessment and treatment planning process so that they know what will be expected of them during the patient's care. The methods of compensating for variations in tooth number and shape will often require contributions from both orthodontist and restorative dentist. The article will highlight the importance of combined planning from the outset and the close relationship between the different specialties, which must be maintained throughout treatment. It will also provide an overview of other areas of patient care which necessitate a multi-disciplinary orthodontic/restorative approach. The aim of this second article in this series of two is to outline a variety of methods which may be used to compensate for variations in tooth shape and number using a combination of orthodontic and restorative approaches. Will discuss the challenges encountered and possible solutions. The first part of this two-part series will discuss the principles of assessment, diagnosis and management. Multidisciplinary planning and delivery of care is essential and ‘mandatory’ in the delivery of optimal outcomes. Often, but not always, it is therefore space closure with camouflaging of the canines as lateral incisors. The ideal treatment is the most conservative one that satisfies the individual’s aesthetic and functional requirements. Treatment planning these cases is multifactorial in nature and the decision ultimately depends on factors such as the malocclusion inter-arch and intra-arch relationship and canine properties (size, colour and shape). Each case presents its own features which will help decision making. There remains debate as to whether, when there is a missing maxillary lateral incisor, if space should be orthodontically opened to allow for prosthetic replacement or closed to camouflage the canines to substitute the absent lateral incisor by recontouring and simple restorative procedures. ![]()
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