Frequently one or both upper lateral incisors are missing, or reduced in size so that they appear unsightly.

When missing the options are to close or open the space. In the latter case, replacement with an implant often is the best final solution. But what happens in the mean time? Implants cannot be placed until alveolar growth had finished - usually after 18 - 20 years of age.

Adhesive bridges provide the interim answer but careful planning is needed to avoid problems that may occur prior to implant placement.

Firstly - the orthodontic treatment MUST provide the correct space for a possible implant AND ensure that the adjacent roots are angulated away from the implant site.

Secondly - the space must be MAINTAINED by holding the crowns AND roots of the adjacent teeth.

On completion of orthodontic treatment is is usual to fit a removable retainer carrying the missing teeth. However over a period of time the roots may relapse and move back into the implant area. Even if an adhesive bridge is fitted soon after removal of the fixed appliance, other movements can occur. For example, a cantilevered lateral incisor pontic may rotate forwards out of position, following movement of abutment canine tooth.

Ideally the lateral incisor pontic should be firmly bonded to both the central incisor and canine abutment teeth, but this has a potential problem of bond failure from one of the supporting teeth and the subsequent problem of how to rebond to this detached abutment tooth.