Treating Congenitally Missing Teeth in a Teenager with Dental Implants

The Challenge

A 16-year-old patient from McLean, Virginia, presented with a condition where she was congenitally missing several teeth, meaning they were missing from birth. She was referred to Elite Prosthetic Dentistry by her orthodontist, who had made significant progress with her orthodontic treatment but recognized that dental implants would be necessary to replace the missing teeth and complete her smile restoration.

In addition to the missing teeth, the patient had a collapsed bite, meaning her upper and lower teeth did not meet properly. This created both functional and aesthetic challenges. Her profile and smile line needed to be enhanced to create proper facial proportions and a natural appearance.

Treatment Approach

The patient’s orthodontist wanted the Elite Prosthetic Dentistry team to take over her case and provide a comprehensive cosmetic smile makeover to replace her missing teeth and establish proper bite relationships. We performed a comprehensive evaluation including three-dimensional imaging and virtual implant planning to develop the optimal treatment approach.

Because the patient’s bite was collapsed but her facial growth had not been completed, we initially recommended that we wait until her dentition was fully established before placing implants. This ensured that the implants would be placed in the proper positions relative to her final facial and dental proportions.

At age 18, after her growth and development had stabilized, we began the implant placement phase. First, we evaluated whether she had sufficient bone volume. Because some areas had limited bone from the congenitally missing teeth, we performed bone grafting procedures to build up the bone in the deficient areas.

Once the bone grafts had integrated (typically 4 to 6 months), we inserted multiple dental implants in precisely calculated positions. Using advanced surgical planning and guides, each implant was positioned to support the final crown at the optimal angle and depth for both function and aesthetics.

After a healing period of 3 to 6 months, we restored the implants with custom, durable, and natural-looking dental crowns. Our in-house laboratory team hand-crafted each crown to match her natural tooth color, shape, and translucency perfectly.

Results

The implant-supported crowns filled in the gaps created by the congenitally missing teeth and restored proper bite relationships. The patient achieved a fully functional and beautiful smile with proper vertical dimensions and facial proportions. Each implant-supported crown is individually crafted to blend seamlessly with her natural teeth.

Why Congenitally Missing Teeth Matter

Congenitally missing teeth present unique challenges because they affect not just the teeth themselves but also bone development and facial growth. A prosthodontist’s expertise in working with orthodontists and managing the timing of implant placement ensures optimal results that last for decades with proper care.

watch: Dr. Marlin Discusses a Case of a Young Teenage Patient with Congenitally Missing Teeth

Today, the patient is a very happy international lawyer and can smile confidently with her new teeth. She can speak, chew, and interact professionally without any concerns about her smile or teeth. Her successful treatment demonstrates how a comprehensive, phased approach to implant dentistry can transform the smile of a young adult with congenitally missing teeth.