Immediate Autotransplantation of Premolar as a Treatment Modality to Replace a Severely Traumatized Central Incisor

Autotransplantation of teeth has been reported by many authors to replace missing teeth, either posterior or anterior, where it became a realistic treatment alternative and useful routine procedure for replacement of teeth in young adolescents where the implant option is relatively contraindicated, particularly to replace teeth lost due to trauma. This paper presents fourteen years old boy, who was referred for the treatment of crown fracture of the maxillary central incisor. Decision was made to extract a mandibular premolar and to transplant it in the site of extracted incisor. At the time of surgery, the central incisor was removed and the mandibular first premolar was transplanted in its socket and splinted with orthodontic multiflex wire for three weeks. Endodontic treatment commenced after one week. The pulp was extirpated and non-setting calcium hydroxide was inserted in the canal and replaced every month for six months, the root was filled with gutta-percha filling material and the crown was reshaped to look like central incisor by composite resin restoration. The patient was then referred for orthodontic treatment.