Orthodontic rehabilitation for anterior teeth lost due to trauma with crowding malocclusion

Herein, we describe orthodontic management for an adolescent girl with traumatic loss of the upper central incisors and maxillary protrusion. The central incisors were immediately replaced and fixed with application of a semi-rigid splint for 12 days, then endodontically treated. Severe root resorption and degeneration of periodontal tissue were noted after 4 years and the teeth were extracted, while the patient had also developed maxillary protrusion with severe crowding in the lower arch. The treatment objectives were to close the spaces by mesial movement of the buccal segment in the upper arch and eliminate crowding by extraction of the lower bicuspids. Favorable occlusion was achieved as was substitution with the lateral incisors for the lost central teeth.