Why agenesis creates a problem of volume, not just space
The teeth most frequently absent due to agenesis are the upper lateral incisors, the second premolars and the wisdom teeth. When a tooth does not develop, neither does the alveolar bone that should have contained it: the stimulus that, during growth, guides the formation and shaping of the ridge is missing. The result is an edentulous site with thin bone and deficient soft tissues.
This is why, in agenesis, placing an implant in a purely mechanical way is not enough to obtain a natural result: it is necessary to rebuild the root eminences and the tissue profile that make a smile harmonious.
How agenesis is treated with the MTM approach
The MTM approach expands the atrophic ridge and places the implant at the same time, letting the periosteum and endosteum regenerate the osteo-muco-periosteal complex in the space created. No bone grafts or membranes are added: the deficient tissues are regenerated by drawing on the patient's own biological resources.
In the typical case of the lateral incisor, this means restoring not only the bone but also the gingival contour and eminence that make the tooth look natural, integrating it with the adjacent teeth.
The advantages in this specific case
- In the great majority of cases a single surgical session is required.
- Smile esthetics: volumes and contours are restored, not only function.
- No exogenous material: no graft, no membrane, no risk of rejection.
- Planning even at a young age, coordinated with any orthodontic treatment.
MTM compared with the alternatives
| Implant with graft / retaining the baby tooth | MTM approach | |
|---|---|---|
| Restoration of volumes | Bone graft, variable esthetic outcomes | Regeneration of the patient's own tissues, natural contours |
| Surgical sessions | Generally multiple | One in most cases |
| Duration | Long, often over 14-18 months | 3-4 months |
| Definitive solution | A retained baby tooth often has a limited lifespan | The implant, integrated and stable over time |
A dedicated assessment, even at a young age
If you or your child live with an agenesis, a timely assessment makes it possible to plan the best time and way to intervene, coordinating the treatment with the stages of growth.
Frequently asked questions
Yes. It is one of the primary indications for MTM. In patients with agenesis the bone volume is reduced because the missing tooth did not guide the development of the ridge. MTM allows the ridge to be expanded and the implant placed in a single session, without bone grafts.
During development the alveolar bone forms and shapes itself around the tooth. If the tooth never developed, the stimulus that guides bone growth is missing and the ridge stays thin. It is a deficit due to a developmental defect, not to the resorption that follows an extraction.
Baby (deciduous) teeth retained into adulthood have resorbed roots and a dystonic morphology. When they fail, the site may present a further deficit. Planning the replacement with an implant in good time, restoring the volumes with MTM, avoids facing the problem in worse conditions.
The aim of MTM is not only to place the implant, but to rebuild the root eminences and the tissue profile that make the restoration look natural. Restoring the osteo-muco-periosteal complex is what unites the functional result with the esthetic one.