Solving the Catch-22 of the Agenesis 12-22- AAO Elie Amm. Episode 7. May 12th 2020

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Hosted by
Farooq Ahmed

Summary of Dr Elie’s research regarding space closure mechanics for missing upper lateral incisors


Patients with missing upper lateral incisors usually have hypoplastic maxilla

Clinical trial investigating mechanics to advance maxilla and close space


  • P: Class 1 / class 3 cases, non-extraction lower arch
  • I: Fixed appliances to close space in the upper arch
  • C: Nil
  • O: Maxillary advancement and inclination change in the upper arch



  • TADs in lower 3-4 region
  • Class 3 elastics from TAD to upper 7s



  • Advancement of maxilla, SNA increase by 1.3o
  • No changes to upper incisor inclination
  • Mesial movement of upper molars 5mm



  • Using treatment protocol, it is possible to advance the maxilla and close space for missing upper lateral incisors



Side affects of counter clockwise rotation of maxilla



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