Biological replacement of maxillary central incisors by transposition of lateral incisors: a 15-year follow-up

Permanent maxillary central incisors are the teeth most frequently affected by traumatic lesions during dentition development. Alterations may occur concurrently with trauma or in the medium- or long-term as a result of posttraumatic complications, ultimately leading to tooth loss due to severe root resorption. Conservative treatment options should be prioritized in these cases with a view to producing a biological response capable of providing growth continuity for the alveolar bone, thereby favoring the functional and aesthetic development of the affected region. This case report describes a patient with congenitally missing mandibular second premolars and severe root resorption of the permanent maxillary central incisors due to traumatic avulsion. The treatment included extraction of the permanent maxillary central incisors and a deciduous second molar, which was then followed by biological replacement by transposition of lateral incisors, mesial movement of posterior segments, and aesthetic and volumetric reconstruction. A 15-year follow-up of the patient is described.