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Multidisciplinary solution for an avulsed upper central incisor: case report.

Stephanie Drummond¹, Lívia Saladini Vieira Pessica, Aline Borges Luiz Monnerat

¹Department of Orthodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil. stepdrummond@yahoo.com

Dental Traumatology : Official Publication of International Association for Dental Traumatology

|May 14, 2011

Summary

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Dental trauma in a teen resulted in avulsed and luxated incisors. Treatment combined orthodontics and prosthetics for esthetics and occlusion without implants.

Area of Science:

Dentistry
Orthodontics
Prosthodontics

Background:

Severe dental trauma during childhood can lead to significant esthetic and functional challenges.
Avulsion and luxation of maxillary incisors require complex management strategies.

Observation:

An 18-year-old female with a history of dental trauma at age 7 presented with an avulsed right central incisor and luxated left central incisor.
The patient also had a Class II malocclusion and severe arch-length discrepancies.

Findings:

Treatment involved extraction of the maxillary left lateral incisor and lower right first bicuspid to facilitate orthodontic space closure.
The maxillary right lateral incisor was repositioned as the central incisor, with canines and first bicuspids assuming adjacent roles.
This approach successfully corrected the malocclusion, improved smile esthetics, and achieved coincident midlines without osseointegrated implants.

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Implications:

Combining orthodontic space closure with prosthetic rehabilitation offers a viable alternative to implants for managing traumatic tooth loss.
This case highlights the importance of a comprehensive treatment plan addressing both occlusion and esthetics in complex dental trauma cases.
Periodontal surgery, bleaching, and porcelain veneers further enhanced the final outcome, demonstrating a multidisciplinary approach.