2. Mesial-distal Space

Important Takeaways from Video:

  • Measure mesiodistal space from contact to contact and root to root
  • 7mm minimum mesiodistal space
  • EXCEPT for laterals and mandibular centrals


So, the second thing that I look for is mesial-distal space. That's contact to contact and root to root. Both of those measurements have to be at least 7 millimeters. Let's take a look at this on a pano. Now, it's not going to be 100% perfect because it's on a pano, but we're measuring right here. Contact to contact and root to root. Both of these have to be at least 7 millimeters, now for molars, a little bit more space is good but 7 millimeters is my bare minimum.

What happens if you don't have 7 millimeters of space? First, the go-to option is Ortho. If you don't have enough space, you can always do ortho and open that space up. The second option, if you're almost there and your roots are already like at least 7 millimeters apart, but your contact is just like 6 millimeters or something, you can do a little bit of an enamel plasty on the adjacent teeth, just to open up that space a little bit.

Now let's take a look at this space up here. This one looks like you have plenty of space in between the roots. So looks like for sure, at least 7 millimeters there, but this contact does not look like you have that required 7 millimeters of space. This would be a case that I would say, Ortho.

The exception to that is mandible incisors and maxillary laterals, those teeth are narrow enough that you can restore them with a 3 millimeter implant. So I'm okay with 6 millimeters of mesial-distal space for those two sites.

Lesson Summary

The second factor to consider in dental evaluations is mesial-distal space. This refers to measuring the space from contact to contact and root to root, with a minimum requirement of 7 millimeters. This measurement is important for determining the feasibility of certain treatments.

In cases where there is insufficient space, the first option is orthodontics. Orthodontic treatment can help create the necessary space. Alternatively, if the roots have sufficient space but the contact area is slightly lacking (e.g., around 6 millimeters), a minor procedure called enameloplasty can be performed on the adjacent teeth to open up the space.

However, for mandibular incisors and maxillary laterals, which are narrow enough, a 3 millimeter implant can be used to restore the missing teeth even with a mesial-distal space of 6 millimeters.

  • Mesial-distal space should be at least 7 millimeters, measured from contact to contact and root to root.
  • If there is insufficient space, orthodontic treatment is the recommended option.
  • In cases where roots have enough space but the contact area lacks a millimeter or so, enameloplasty can help create the necessary space.
  • Mandibular incisors and maxillary laterals can be restored with a 3 millimeter implant even with a 6 millimeter mesial-distal space.

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