He had edge-to-edge Class II molar and canine relationships, mild crowding in both arches, a 5mm overjet, and a 4mm overbite. The patient exhibited a well-balanced and symmetrical face with a convex facial profile and normal vertical proportions ( Fig. Since reimplantation of the avulsed tooth was not possible due to multiple root fractures, he had received a Maryland bridge to restore esthetics and maintain space. Case ReportĪ 14-year-old male who had lost his upper right central incisor from trauma was referred for orthodontic assessment. Interdisciplinary collaboration between orthodontists and other dentists, such as oral surgeons, prosthodontists, and general practitioners, appears to be of increasing importance in these cases. 4,5 The advantage of orthodontic treatment is that a concomitant malocclusion can be treated simultaneously. Treatment alternatives include reimplantation of the avulsed tooth, autotransplantation, waiting until early adulthood to place a bridge or an implant, or substituting the central incisor with the lateral incisor after orthodontic space closure. In addition, parents who are concerned about psychosocial pressures usually want early resolution of their children’s esthetic problems. 1,2 The need to maintain alveolar bone until growth has ceased presents a particular dilemma if implants are required. Many factors complicate the diagnosis and treatment of growing children with missing maxillary central or lateral incisors.
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