title: Multidisciplinary solution for an avulsed upper central incisor: case report.
abstract: This case report refers to an 18-year-old female who suffered from dental trauma when she was 7 years old caused by a bicycle accident. Her maxillary right central incisor was avulsed, and the left one was extrusively luxated. The left central incisor was correctly repositioned and immobilized with a semi-rigid splint. The right one could not be found. She presented with class II malocclusion and severe negative arch-length discrepancies in both arches. The treatment objectives were the following: recover smile esthetics by replacing the maxillary right central incisor, correct the class II relationship, and optimally reduce mandibular and maxillary crowding. Extractions of the maxillary left lateral incisor and the lower right first bicuspid were performed; thus, the maxillary right lateral incisor would function as a maxillary right central incisor, the canines would function as lateral incisors, and the first bicuspids would function as canines. This allowed for the malocclusion to be corrected while simultaneously reestablishing the smile esthetics, without the use of an osseointegrated implant. A good occlusion with coincident upper and lower midlines was achieved. After orthodontic therapy, the patient underwent periodontal surgery to improve her gingival margins. Subsequent teeth bleaching was performed, and the patient received six porcelain veneers. A combination of orthodontic space closure and prosthetic rehabilitation may be the best treatment option after severe traumatic tooth loss.
authors.affiliation: Department of Orthodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil. stepdrummond@yahoo.com
authors.forename: Stephanie
authors.initials: S
authors.lastname: Drummond
authors.forename: Lívia Saladini Vieira
authors.initials: LS
authors.lastname: Pessica
authors.forename: Aline Borges Luiz
authors.initials: AB
authors.lastname: Monnerat
authors.forename: Antonio Fernando
authors.initials: AF
authors.lastname: Monnerat
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: de Oliveira Almeida
mesh_terms: D000293:Adolescent; D003776:Dental Porcelain; D003801:Dental Veneers; D004955:Esthetics, Dental; D005260:Female; D005893:Gingivoplasty; D006801:Humans; D007180:Incisor / Q000293:injuries*; D008312:Malocclusion, Angle Class II / Q000628:therapy; D019516:Orthodontic Space Closure / Q000379:methods; D010347:Patient Care Planning; D012904:Smiling; D014084:Tooth Avulsion / Q000628:therapy*; D014073:Tooth Bleaching; D016388:Tooth Loss / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D003776:Dental Porcelain