Abstract
A four year one month old Japanese male was referred to the Nippon Dental University for oral evaluation and treatment. The medical history was noncontributory. Oral examinations revealed rampant dental caries with fistula on the upper right second primary molor. The upper left second primary molor had already been extracted. Radiographic evaluation showed congenitally missing lateral tooth.
Treatment and follow-up
Endodontic therapy was done by means of root canal treatment on the upper left second primary molar. However, because of endodontic failure, a radectomy was performed.
A distal shoe space maintainer was inserted on the opposite side.
Later, the first primary molars exfoliated naturally. However, the patent did not return to the clinic immediately and the first permanent molar moved mesially.
To distalize the upper right first permanent molar, a Howly type space regainer was inserted. It was successfully performed.
The molar relationship was Angle Class 1 on the right side and Angle Class 2 on the opposite side.
The dentist may be able to assist a patient with congenitally missing teeth to develop a good occlusion by means of long-term follow-up intervention. With the aid of simple appliances he may help the child during the transition from the primary to the permanent dentition by preventing complicated future orthodontic problems. The occlusal management of the children was performed without bridges and by utilizing the physiological mesial movement of the permanent teeth (3 4 5 6).
