Recent advances in restorative and surgical materials and techniques have increased the treatment options available for patients who are missing an anterior tooth. The factors influencing the management of such patients and the orthodontic implications of these treatment options are discussed in this paper.

Restorative procedures which complement orthodontic treatment and which may be carried out by the orthodontist are summarized. The importance of planning, with the restorative requirements in mind and the maintenance of prepared space (individual tooth or abutment positions) in all three planes of space during the period of retention, is described. The importance of liaison regarding the timing of the placement of the definitive restoration, if it is to be carried out by another dental surgeon, is stressed.

Orthodontic treatment decisions when maxillary central incisors are absent or are of poor prognosis, are discussed. Autotransplantation of mandibular first premolars to the incisor region is suggested as an approach in selected cases. The literature is reviewed, surgical technique described and case selection summarized. Cases are reported where autotransplantation of premolars to the maxillary incisor region has produced good functional and aesthetic results.

The increased awareness of the possible harmful effects of ionizing radiation has resulted in concern at the number of panoramic radiographs taken in General Dental Practice. A study has been carried out to examine the diagnostic value obtained from panoramic radiographs taken at 9-10 years of age. Nine-hundred-and-eighty-two radiographs were examined and 261 (26.5 per cent) showed findings which would be of significance in orthodontic diagnosis and treatment planning.

In Part 1 the literature on the direction and moment force systems of headgear therapy was discussed. The magnitude and duration of forces were briefly dealt with. In Part 2 the clinical response to the main directions of headgear force as reported in the literature will be described. Recommendations on the most appropriate direction and moment force systems for particular clinical situations will be made.

The literature of headgear therapy is reviewed and used to explain some of the theoretical mechanical principles of tooth movement and anchorage control achieved by this method. Part 1, Mechanical Principles, is a review of force directions, centres of rotation, force magnitude and duration. In Part 2, Clinical Response and Usage, the clinical uses of different directions of force are examined. Some of the clinical research into the changes produced by different headgears is described. An attempt is made to draw conclusions from the theoretical concepts discussed which may be of aid to the clinician.