Missing Lateral Incisors: Beyond Space Closure

with Dr Nour E Tarraf


Missing lateral incisors present a unique challenge for orthodontists. As they are usually diagnosed in children, closing the lateral incisor spaces can avoid compelling the child to a lifelong commitment to prosthetic dentistry. However, the results were often criticised for producing unnatural or imperfect looking smiles.

With the introduction of TADS, the anchorage challenge in closing spaces for missing laterals has been largely resolved. Yet there are still some aesthetic short comings.

This lecture will address some of the reasons for considering space closure for ALL children with missing lateral incisors. I will explore some the available skeletal anchorage set-ups to achieve predictable results and will challenge some old beliefs regarding space closure being contraindicated in cases with a Class III skeletal pattern.

I will also show some novel appliance designs and biomechanical concepts that can help us deliver a natural and full smile in cases with missing lateral incisors.


Nour finished his BDS at Cairo University with Honors in 2001 followed by an orthodontic residency at Cairo University. He then moved to Sydney where he completed his Masters degree in Orthodontics at the University of Sydney in 2008 with Honors.

He works in private practice in Chatswood, Sydney and is involved in research and teaching at the University of Sydney.

Nour has a special interest in invisible orthodontic techniques such as lingual orthodontics and Invisalign. He is the past president of the Australasian Society Of Lingual Orthodontics.

He is also the first and only Australian to become a Titular member of the European Society of Lingual Orthodontics and an Active member of the World Society of Lingual Orthodontics.

Among his special interests are the use of digital technology in orthodontics, early orthodontics and growth modification treatment and he recently completed a PhD on the application of skeletal anchorage in maxillary growth modification for growing children. He has lectured nationally and internationally and has number of scientific publications.