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VOLUME 15 , ISSUE 1 ( January-June, 2023 ) > List of Articles


Direct Composite Build-up of an Ankylosed, Discolored, and Infraoccluded Upper Lateral Incisor: An Esthetic Management Case Report

Pantelis Kouros, Georgia Vourtsa, Nikolaos Topouzelis, Aristidis Arhakis

Keywords : Ankylosis, Avulsion, Case report, Infraocclusion, Esthetic management

Citation Information : Kouros P, Vourtsa G, Topouzelis N, Arhakis A. Direct Composite Build-up of an Ankylosed, Discolored, and Infraoccluded Upper Lateral Incisor: An Esthetic Management Case Report. CODS J Dent 2023; 15 (1):16-20.

DOI: 10.5005/jp-journals-10063-0144

License: CC BY-NC 4.0

Published Online: 25-04-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: This case report aims to illustrate the management of an avulsed maxillary lateral incisor in a young orthodontic patient, highlighting the interim esthetic solution employed before implant rehabilitation. Background: Traumatic dental injuries, especially avulsion of permanent teeth, are common in children and adolescents and can pose challenges for treatment, particularly in patients undergoing orthodontic therapy. This case study explores the management of an avulsed maxillary lateral incisor in an 11-year-old female patient undergoing orthodontic treatment, emphasizing the complexities of trauma in orthodontic patients and the subsequent need for esthetic rehabilitation. Case description: Following an accident, the patient experienced avulsion of the upper left lateral incisor, which remained extraoral for 2.5 hours before repositioning. Concurrently, the patient was undergoing orthodontic treatment using a mobile device. Due to trauma, the tooth required endodontic treatment and was excluded from orthodontic intervention. By age 15, post-orthodontic treatment, the infraoccluded and ankylosed tooth showed no clinical or radiographic symptoms. The patient requested an esthetic solution while awaiting planned implant rehabilitation at age 18. Conclusion: The employed approach involving tooth contouring, flap repositioning, resin composite restoration, and color matching techniques provided a satisfactory esthetic outcome. This interim solution addressed the patient's aesthetic concerns while preparing for definitive implant rehabilitation. Clinical significance: This case underscores the importance of interdisciplinary collaboration and patient-centered care in managing traumatic dental injuries in orthodontic patients. It emphasizes the need for comprehensive treatment planning and esthetic interim solutions to enhance patient satisfaction during the waiting period for definitive treatment.

  1. Fouad AF, Abbott PV, Tsilingaridis G, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2020;36(4):331–342. DOI: 10.1111/edt.12573
  2. Tondelli PM, Mendonça MR, Cuoghi OA, et al. Knowledge on dental trauma and orthodontic tooth movement held by a group of orthodontists. Braz Oral Res 2010;24(1):76–82. DOI: 10.1590/s1806-83242010000100013
  3. Oskoee SS, Bahari M, Daneshpooy M, et al. Effect of different intraorifice barriers and bleaching agents on the fracture resistance of endodontically treated anterior teeth. J Endod 2018;44(11):1731–1735. DOI: 10.1016/j.joen.2018.07.025
  4. American Academy of Pediatric Dentistry. Clinical Affairs Committee – Restorative Dentistry Subcommittee. Guideline on pediatric restorative dentistry. Pediatr Dent 2012;34(5):173–180.
  5. Tarnow DP. Semilunar coronally repositioned flap. J Clin Periodontol 1986;13(3):182–185. DOI: 10.1111/j.1600-051x.1986.tb01456.x
  6. Vanini L. Conservative Composite Restorations that Mimic Nature. J Cosmet Dent 2010;26:81–101.
  7. Seshima F, Ota M, Kinumatsu T, et al. Effect of recombinant basic fibroblast growth factor on reimplanted teeth in beagle dogs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(1):142–148. DOI: 10.1016/j.tripleo.2009.07.055
  8. Panzarini SR, Gulinelli JL, Poi WR, et al. Treatment of root surface in delayed tooth replantation: a review of literature. Dent Traumatol 2008;24(3):277–282. DOI: 10.1111/j.1600-9657.2008.00555.x
  9. Pithon MM. Surgical luxation and orthodontic traction of an ankylosed upper first molar. J Clin Orthod 2016;50(5):299–306.
  10. Medeiros PJ, Bezerra AR. Treatment of an ankylosed central incisor by single-tooth dento-osseous osteotomy. Am J Orthod Dentofacial Orthop 1997;112(5):496–501. DOI: 10.1016/s0889-5406(97)70076-3
  11. Agabiti I, Capparè P, Gherlone EF, et al. New surgical technique and distraction osteogenesis for ankylosed dental movement. J Craniofac Surg 2014;25(3):828–830. DOI: 10.1097/SCS.0000000000000737
  12. Einy S, Kridin K, Kaufman AY, et al. Immediate post-operative rehabilitation after decoronation. A systematic review. Dent Traumatol 2020;36(2):141–150. DOI: 10.1111/edt.12513
  13. Kanzow P, Wiegand A. Retrospective analysis on the repair vs. replacement of composite restorations. Dent Mater 2020;36(1):108–118. DOI: 10.1016/
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