Orthodontic movement through a repaired buccal alveolar fracture: a case report

Orthodontic treatment in adults often involved the extraction of a lower central incisor. The extraction of these teeth can be problematic. Some factors that can influence successful treatment include: difficult access for actual tooth removal; the existing contour and bulk of the alveolar ridge; the buccal tooth position; and the inclination of the tooth in the alveolus. A patient who had a lower central incisor removed experienced a buccal alveolar fracture because of thin buccal plate. Upon healing there was a buccal defect that prevented the later tooth movement that would have closed the extraction site. The area was grafted with a demineralized freeze dried bone allograft to provide a matrix for osteoinduction. Gore-Tex was used as the physical barrier. After 6 months, the extraction side was closed by passing the lateral incisor through the graft site. The result was good tooth alignment and slight horizontal bone loss in the defect area.