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Tooth loss after trauma may occur immediately or after some time due to complications. For grown-up patients the typical prothetic treatment options (implants, bridges) are available. In growing patients these definite treatments are not possible.

After tooth loos the bone is reduced in height and thickness. Therefore implants should inserted soon after tooth loss; successful integrated implants maintain bone.
Since in growing patients implantations are not possible, there will be a
dramatic loss of bone over the years. When implants are planned after the end of growth bone must be augmented by difficult surgical interventions.

In some situations and age groups it is possible to transplant premolars (bicuspidy) or primary canines to the region of a lost front tooth. These transplants have a different shape of the tooth crown, however this can be easily corrected. The grate advantage is a definite treatment already during the growth. The bone is maintained. The use of removable prothesis for many years can be avoided. The treatment produces relatively low costs.

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Transplantation of premolars

The transplantation of premolars (bicuspids) is a treatment method that is used for a long time however barely known. Healing results and long-term survival are excellent, the esthetics are mostly great. A major advantage is the emergence from the gingiva - the typical situation of a sound tooth.
A prerequisite is that a premolar is “available”. Therefore transplantations of premolars are possible when teeth need to be extracted during an orthodontic treatment.
The healing results are dependent on the root development which can be determined on radiographs. Mostly transplantation is optimal in the age of about 10 to 13 years.

Ankylosis after tooth injury. The development of the alveolar bone is stopped.

Transplantation of a premolar.

Reconstruction using composite, 5 years after transplantation. Further development of alveolar bone. No loss of bone and gingiva.

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Transplantation of primary canines

The transplantation of primary canines is a new method. However the first results are promising.
Primary canines are lost during the changing of teeth. As long as the root is not resorbed too much by the successor, a primary canine can be transplanted. Typically the patients are about 6 to 10 years - an age in which transplantations of premolars are not yet possible.

Transplantation of 2 primary canines.

Reconstruction with composite.
Tissues maintained. Good esthetics.

 

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