Corrections of Dental Anomalies in the Maxillary Incisors and Their Influence on Perceived Smile Esthetics: A Systematic Review

Introduction: Dental anomalies present a significant challenge to clinicians due to their impact on both dental function and esthetics. The correction of these anomalies plays a critical role in improving the quality of life of our patients, highlighting the importance of this restorative work. Objective: The purpose of this systematic review is to assess the techniques used to restore various dental anomalies, and their subsequent esthetic impact on the overall dentition. Methods: Inclusion criteria consisted of restorative rehabilitations of the permanent dentition in non-syndromic patients with dental anomalies of morphology, structure, size, and number in the maxillary incisors. Exclusion criteria included surgical rehabilitation techniques, endodontic treatments, and anomalies of the primary dentition. The medical literature was systematically searched (Pubmed, PMC, Embase, Cochrane Central Register of Controlled Clinical trials, Scopus and Google Scholar) to identify all relevant articles reporting data regarding the chosen anomalies. ROBINS-I was used to assess the risk of bias tool, and the results were tabulate due to data heterogeneity. Results: Of the 1821 analyzed articles, 46 articles met the inclusion criteria, and were chosen to go through the final review procedure. Of the selected articles, 3 investigated amelogenesis imperfecta and dentinogenesis imperfecta, 1 analyzed conoid teeth, 1 considered hypodontia (other than MLIA), 3 concerned microdontia (excluding peg laterals and conoid teeth), 10 evaluated peg-shaped laterals, 2 investigated talon cusps and geminated teeth, 15 were regarding maxillary lateral incisor agenesis, and 11 papers were related to the perception of anomalies. Conclusions: Pre-visualization using Digital Smile Design, a treatment plan encompassing minimally invasive restorations, and using a multidisciplinary approach among practitioners helps the anomalous patient achieve the best possible esthetic result.