Implant and Prosthetic Treatment in Esthetic Zone with Alveolar Ridge Preservation and Autotransplantation: Clinical Case Report with 16-year Follow-up

Occlusal reconstruction comprising orthodontic treatment, autotransplantation, and implant treatment was performed in a 30-year-old woman with missing maxillary anterior teeth. An initial examination revealed marked root resorption of the maxillary anterior teeth. Both the maxillary canines were missing, causing constriction of the dental arch. Conserving the right maxillary central and lateral incisors, which were dislocated due to trauma, was considered to be too difficult, and a bridge was not selected as there was insufficient load bearing capacity in the adjacent abutment teeth, making the prognosis uncertain. Partial dentures were rejected due to the patient's age and esthetic demands. First, the right mandibular lateral incisor was extracted to relieve crowding in the mandibular anterior teeth, leaving the patient with 3 mandibular incisors. Orthodontic treatment was then performed to harmonize the occlusal relationship between the mandibular and maxillary anterior teeth. Next, the right mandibular lateral incisor was transplanted to the extraction site of the right maxillary lateral incisor. After fixation of the autotransplanted tooth, the shape of the bone around the implant site improved. The final prosthesis for the right maxillary central incisor was provided via implant treatment. As seen in a follow-up 16 years later, the interproximal dental papilla was intact, and the patient's esthetic demands were fulfilled. Utilizing the functions of the periodontal ligament of the natural teeth was a useful part of orthodontic treatment and autotransplantation.