Premolar transplantation to replace a missing central incisor

• A 10-year-old boy, physically healthy, with history of dental trauma and absence of the maxillary right central incisor, was evaluated.
• The selected treatment was to transplant the mandibular right second premolar to the maxillary right central incisor region, where there was bone loss.
• Results showed cortical bone gain on the transplanted tooth's buccal root, and 9-year follow-up radiography showed healthy periodontal support tissue.

During childhood, the anterior maxilla is susceptible to injury, and the loss of incisors is one of the most serious injuries. In many cases, autotransplantation is the best alternative for children who lose an incisor during the growth phase. This case report describes the treatment of a boy who had a traumatic injury when he was 8 years old that resulted in avulsion of the maxillary right central incisor. When he sought treatment at age 10, the space was lost as was bone in the incisor region. Because he lacked space in the mandibular arch for proper tooth alignment, extractions were planned. One extracted premolar was transplanted into the space of the missing maxillary incisor area. The posttreatment results were good, and follow-up records 7 and 9 years after treatment showed healthy periodontal support and cortical bone gain in the transplanted tooth's buccal area.