Maxillary Left Central Incisor Research Articles

A feasibility study on the use of an intraoral optical coherence tomography system for scanning the subgingival finish line for the fabrication of zirconia crowns: An evaluation of the marginal and internal fit

ObjectivesThis study aimed to evaluate the marginal and internal fit of zirconia crowns were fabricated using scan data from an intraoral optical coherence tomography (OCT) scanner and an intraoral scanner (IOS) for scanning the subgingival finish line. MethodsAn extracted maxillary left central incisor was prepared for a zirconia crown. The prepared tooth was placed in artificial gingiva, created using silicone with a refractive index similar to that of the tooth, ensuring a subgingival depth of 0.50 to 0.70 mm from the labial finish line. Scanning data were obtained from four types of models as follows. (1) CAD reference model (CRM) excluding the gingiva and scanned using a laboratory scanner. (2) IOS group excluding the gingiva (IOS only, IOSO group). (3) IOS group with scanned attached artificial (IOS with gingiva, IOSG group). (4) OCT post-processed data of the subgingival finish line and IOSG data (OCT group). Zirconia crowns were fabricated based on these data, and their marginal and internal fit were evaluated using the silicone replica technique. Statistical analyses were conducted using one-way and two-way ANOVA (α = 0.05). ResultsThe OCT group exhibited a significantly smaller marginal gap than the IOSG group (P < 0.05). The marginal fit of the OCT group did not significantly differ from that of the CRM group (P > 0.05). The IOSG group exhibited a significantly larger chamfer gap, while both the IOSG and OCT groups had significantly larger axial gaps. Furthermore, the OCT group showed a significantly larger incisal gap (P < 0.05). ConclusionsAn intraoral OCT system can enhance the fabrication accuracy of zirconia crowns by achieving superior marginal fit for crowns with subgingival finish lines. Clinical significanceThe use of an IOS for subgingival finish lines without gingival displacement cords may result in a suboptimal marginal fit. However, integrating OCT technology can effectively address this issue, leading to improved clinical outcomes.

Endodontic and Surgical Management of Trauma-Induced Combined Internal and External Root Resorption with Periapical Cyst: A Case Report

Root resorption, involving the breakdown of hard tissues like dentin and cementum, can result from trauma and subsequent infection, potentially leading to tooth loss. This case report details the management of combined internal and external root resorption with a periapical cyst in a 32-year-old male. After trauma, the maxillary left central incisor (#21) presented with root resorption and a displaced apex. Endodontic treatment using MTA and surgical enucleation of the cyst were performed. A 12-month follow-up showed successful resolution and tissue regeneration. This case emphasizes the effectiveness of combining advanced endodontic and surgical techniques for complex resorption cases.

Comparative evaluation of the position of incisive canal and its proximity to the maxillary central incisor roots with different incisor inclinations – A CBCT study

Objectives: The aim of this study was to evaluate and compare the incisive canal position and its proximity to maxillary central incisor roots at different incisor inclinations. Material and Methods: A 105 CBCT samples have been then divided into three groups on the basis of U1-SN and U1-NA when traced on lateral cephalogram into normal, proclined, and retroclined. Several linear measurements have been made in the axial plane at three different levels, that are palatal opening, mid-root level, and apex, in relation to the incisive canal. Angular measurements were also made in the sagittal plane. Results: A significant difference was found between the proximity of the maxillary right and left central incisor to the incisive canal in the proclined and retroclined group at the mid-root level and at the apex. There has been a major variation between the angles developed by the incisive canal to the palatal plane in all three groups. A significant correlation was also found between the angle formed by the incisive canal to the palatal plane and the tooth’s long axis to the palatal plane. Conclusion: The proclined group exhibits the shortest distance between the incisive canal and the incisors, implying the need for meticulous planning in Class II Division 1 and bimaxillary protrusion cases. This planning is crucial when aiming for extensive retraction and intrusion to prevent any contact with an incisive canal, thus reducing the root resorption risk.

A multifunctional scannable mounting device for computer guided implant surgery: An in vitro study

As part of the growing digitization of the dental field, clinicians are looking for ways to simplify digital workflow, reduce chairside time, and provide new work patterns for future applications. Whether scanning with a multifunctional apparatus (MFA) scan body results in improved scanning is unclear. The purpose of this in vitro study was to compare the horizontal, vertical, and angular deviations with the MFA scan body with a commercially available scan body (SBIO). Sixteen identically printed edentulous maxillary models were used to plan two Ø3.8×11.5-mm implants in the right maxillary first molar and left maxillary central incisor locations. Two implants in each model were installed using a surgical guide. The models were scanned using an intraoral scanner with MFA and then rescanned twice, with SBIO using the intraoral scanner and a laboratory 3D scanner. The implants were digitally positioned according to the scanned MFA and SBIO locations in standard tessellation language (STL) files. These STL files were superimposed on the reference laboratory 3D scanner STL files. Linear measurements included implant apex/cervical horizontal/vertical deviations, as well as implant axis angular deviations. Normality was evaluated with the Shapiro-Wilk test. Paired samples t tests (2 sided) were used for the mean SBIO-MFA deviation difference. To compare the molar/incisor sites, paired samples Wilcoxon tests were used (α=.05 for all tests). No statistically significant differences were found between the MFA/ SBIO deviations, for each of the 10 sites × deviation combinations (P>.05). Overall, the lowest endpoint of the 95% confidence intervals among the 8 linear measurement comparisons was -0.107 mm (coronal vertical deviation, right maxillary first molar site) and -0.30 degrees between the 2 angular measurement comparisons. The current in vitro study demonstrated high accuracy for the novel MFA device, similar to that of the standard SBIO scan body. Furthermore, the current study offers an alternative technique to evaluate the accuracy of implant placement by using scanning and back programming over the traditional postplacement cone beam computed tomography (CBCT) scanning.

Validation of finite-element-simulated orthodontic forces produced by thermoplastic aligners: Effect of aligner geometry and creep

PurposeFinite element (FE) models for determining the orthodontic forces delivered by clear aligners often lack validation. The aim of this study was to develop and validate accurate FE models for clear aligners, considering the small but important geometrical variations from the thermoforming process and the creep behavior of the aligner material. Methods and materialsThe tooth misalignment considered was a 2.4° torque aberration (rotation about the mesial-distal axis at the level of the center of resistance) of the maxillary left central incisor. FE models were created from Micro-CT scans of a model dental arch and five nominally identical aligners with the aforementioned misfit. Fitting of the aligners onto the dental arch was simulated using Abaqus's Interference Fit function, followed by surface-to-surface frictional interaction. Stress relaxation of the aligner material was measured using double-cantilever beam bending and modeled with a Prony series. The assembled FE models were validated by comparing the predicted forces and moments delivered to the maxillary left central incisor with experimental data, obtained with a custom-built but fully calibrated apparatus. ResultsGood agreement between prediction and measurement was obtained for both the short- and long-term forces and moments. In the short-term, i.e., after 30 s, the dominant force in the labial-lingual direction had a maximum difference of 2.9% between experiment and simulation, and the dominant moment about the mesial-distal axis had a maximum difference of 8.3%. In the long-term, i.e., after 4 h, the experimental and numerical forces had a maximum difference of 8.4%. There were statistically significant differences in the forces delivered among the nominally identical aligners, which were predicted by the geometrically accurate FE models and attributed to the variations in the points of contact between the aligners and the dental arch. The decay in force applied was affected by both the viscoelastic material behavior and friction between the aligner and arch. ConclusionFor accurate prediction of the forces and moments delivered by thermoplastic aligners, FE models that can accurately capture the point contacts between the aligners and the underlying teeth are essential. Stress relaxation of the aligners could be adequately modeled using the Prony series to represent the temporal changes of their elastic modulus.

Surgical Management of Palatally Impacted Mesiodens in a Pediatric Patient: A Case Report

Supernumerary teeth are additional teeth or tooth-like structures that can develop either erupted or unerupted, beyond the normal complement of 20 primary teeth and 32 permanent teeth. A mesiodens is a specific type of supernumerary tooth located in the midline between the two central incisors. The presence of these extra teeth can lead to various clinical complications. This paper presents a case involving a palatally positioned, impacted mesiodens that was associated with an unerupted permanent left maxillary central incisor. Surgical removal of the mesiodens was performed, resulting in the successful eruption of the permanent incisor.

Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A micro-computed tomography study

Aim: The aim of this study is to investigate the stress distribution created by two restorative techniques, adhesive reattachment of the fractured fragment and direct composite restoration, used in the treatment of a maxillary central incisor with enamel-dentin fracture. The analysis is conducted using the finite element stress analysis method on a three-dimensional (3D) model prepared based on micro-computed tomography data, following the application of different adhesive procedures on fractured teeth. Methodology: The avulsed left maxillary central incisor was scanned using a micro-computed tomography device. The obtained data was transferred to a computer and used for 3D modeling. In the models, a fracture line was created obliquely at a 45° angle, 3 mm away from the mesial surface towards the distoincisal corner of the tooth. Six restorations were planned on this model: three direct composite restorations and three adhesives, reattachments followed by composite application. The models for the adhesive reattachment method included: (1) internal dentin groove, (2) palatal composite laminate veneer, and (3) double palatal retentive groove. The models for the composite restoration technique included: (1) composite laminate veneer, (2) direct composite restoration following enamel beveling, and (3) composite application after double palatal groove preparation. Upon completion of the restorations, a 100-N force was applied from the palatal direction using the finite element stress analysis method. The results were analyzed to examine the amount and distribution of stress on the restorations and the tooth. Results: In all models, the highest stress values within tooth structures were observed in the enamel. The lowest stress value in the enamel layer was seen in model R-1, whereas the highest stress value was observed in model K-2. For direct composite restorations, the stresses on enamel, dentin, and restoration were relatively similar in each model, with no significant differences noted among these values. Among all applied composite restorations, the lowest stress value was observed in model R-3. When analyzing the stresses generated at the tooth-restoration and tooth-fractured fragment interface of the six models, the lowest stress in the enamel was observed in models R-1 and K-3, while the highest stress was seen in model R-3. Conclusion: According to the data obtained from the models, the shape of the restoration applied on the tooth, the technique used, and the location of the restoration affect the amount and distribution of stress accumulated in the tooth and restoration. However, the stress analysis results are not sufficient to evaluate the clinical success of restorations. There is a need for further studies utilizing different techniques to support the models used. How to cite this article: Olgaç Akgönül Ş, Çelenk S, Adıgüzel Ö. Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A finite element analysis based on micro-computed tomography data. Int Dent Res 2024;14(2):76-83. https://doi.org/10.5577/intdentres.535

Root canal configuration of human permanent anterior teeth: A cross-sectional study using cone-beam computed tomography in the Pakistani population.

To analyse and document internal root morphological variations in permanent anterior teeth using conebeam computed tomography. The cross-sectional, retrospective study was conducted from January 21 to June 19, 2021, at Jinnah Magnetic Resonance Imaging and Body Scan, and comprised data from July to December 2020 related to all the patients who had been referred to the centre for dental cone-beam computed tomography scan. The scans were evaluated at the Radiology Department of the School of Dentistry at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. The morphology of the roots and root canals in all permanent anterior teeth was examined. Root canal configuration was categorised using Vertucci's classification. Data was analysed using SPSS 20. Of the 211 patients, 116(55%) were females and 95(45%) were males. The overall mean age was 39.9±1.02 years (range: 15-65 years). All the permanent anterior teeth exhibited a single root, with the exception 2(0.9%) mandibular right and 4(1.9%) left canines which had double roots. Type I root canals were observed in all 211 (100%) maxillary right central incisors, maxillary left central incisors and maxillary left canines. Among maxillary right canines, 208(98.6%) had type-I root canals, and the corresponding value for maxillary right lateral incisors was 209(99.1%), and for maxillary left lateral incisors, the value was 210(99.5%). Root canal polymorphism had no significant association with gender (p>0.05). The presence of type-I root canal was common in permanent anterior teeth, and there was significant association of root canal polymorphism with gender.

Reattachment of Fractured Tooth Segment in Minimally Invasive Way - A Case Report

Dental trauma frequently results in coronal fractures of the front teeth. Root canal therapy followed by reattaching the fractured segment with fiber post reinforcement is a viable alternative in cases of complex fractures where the fractured segment is present and there is close approximation of the segment to the intact tooth. Reattaching a fractured piece is a quicker, less involved process that offers immediate relief, better aesthetics, and function restoration. The present case report is of a 11-year-old boy with an uncomplicated crown fracture of permanent maxillary right central incisor and a palatal uncomplicated crown–root fracture of his permanent maxillary left central incisor . The fractured fragment was reattached using nano-filled dual-cure composite resin and tooth restored with composite resin. The fragment showed opaque discoloration that reduced over time but still persisted after 1 year. During the follow-up period, no unfavorable radiographic changes were seen. The prognosis of the teeth was favorable with good esthetic results. Keywords: Fragment reattachment, Fragment rehydration, Periodontal health, Root fracture, Uncomplicated crown.

Surgical and orthodontic management of impacted maxillary central incisor in children: A case report

Impaction of maxillary permanent central incisor is a frequently reported case in dental practice, and its treatment is challenging because maxillary central incisors are of great important for both aesthetic and functional aspects, since they provide support of the lip and facial muscles. Early detection of such teeth is most important if complications are to be avoided. In this article, we report a case of a 12-year-old girl, in the Pediatric Dentistry Specialist, Dental and Oral Hospital, Airlangga University. Combined approach with surgical exposure and the application of an orthodontic force brought the impacted left maxillary central incisor down to its proper position in the dental arch.

Age Estimation Using the Pulp-to-Tooth Area Ratio in an Indian Population Using Cone-Beam Computerised Tomography (CBCT): A Retrospective Study.

Age estimation, whether for living or deceased individuals, is crucial in forensic sciences. Traditionally, the pulp-to-tooth area ratio determined from periapical radiographs has been employed as a non-invasive method for estimating age. Cone-beam computed tomography (CBCT) represents a newer technique, providing three-dimensional images of teeth in living individuals. This study aims to estimate age using the pulp-to-tooth area ratio of four teeth (the permanent maxillary central incisor, lateral incisor, canine, and first premolar. The study included ninety subjects ranging in age from 18 to 70 years. This study concluded that the correlation between actual age and estimated age varied across different tooth types. There was a strong positive correlation between the maxillary right central incisor and maxillary right canine tooth, while the maxillary left canine tooth exhibited a slightly weaker but still positive correlation. This indicates that the maxillary right central incisor and maxillary right canine tooth are the most reliable for estimating age. Additionally, the study found that the linear regression results for estimating age based on the pulp-to-tooth area ratio, categorised by sex and each type of tooth, showed strong associations between age and the ratio for the maxillary left central incisor and maxillary left canine teeth in males, and for the maxillary left central incisor in females.

Management of avulsion-induced external root resorption of permanent maxillary left central and lateral incisors - a one-year follow-up case report

The presented case elicits the successful management of external root resorption in an avulsed permanent central and lateral incisor due to failure to initiate root canal treatment (RCT) at the right time and prolonged splinting. A 13-year-old female child reported a complaint of pain in her upper anterior teeth region. The child gave a history of avulsed 21 and 22, which was replanted. External inflammatory root resorption in (21 and 22) and peri apical abscess (11) was noted in the radiograph. External inflammatory root resorption was treated endodontically with corticosteroid-antibiotic medicaments and obturated with mineral trioxide aggregate (MTA). Obturation was done only after restoring tooth stability and symptom resolution. Replacement resorption was noted radiographically during the follow-up visit. This case underscores the importance of meticulous endodontic care and adherence to treatment timelines, providing valuable insights for clinicians managing similar challenging cases.

Dens in dente: A review of literature with a rare case report

Dens invaginatus (DI) (dens in dente) is a developmental anomaly resulting from an invagination in part of variable depth of the enamel organ into the dental papilla in the surface of the crown before calcification of the dental tissues. They are a target for caries leading to pulp necrosis and apical pathosis, so the diagnosis and early prevention measures are important. When treatment is necessary, conservative, endodontic, and periodontal possibilities are very effective. Surgical interventions are only rarely indicated. This article presents a unique case report of unilateral DI of Type III (Ohlers) involving the maxillary left central incisor as well as a comprehensive review of literature on history, aetiology and classification. Early detection and management are recommended before the development of pulpal and periodontal pathosis that further complicates the prognosis. Postoperative follow-up subsequent to treatment is essential for effective long-term clinical management.

Fracture resistance of cement-retained lithium disilicate implant-supported crowns: Effect of material used for two-piece abutments.

This study compared the fracture strength of single lithium disilicate implant-supported crowns fabricated on two-piece abutments with various materials: ceramic-reinforced PEEK, zirconia, and lithium disilicate. Thirty-six implants were embedded in acrylic cylinders. A two-piece abutment and a crown were designed following a pre-operation scan for a maxillary left central incisor. The designed crown was used to fabricate 36 lithium disilicate crowns. The designed abutment was used to manufacture 36 abutments from 3 materials, 12 each: (A) zirconia; (B) lithium disilicate; and (C) ceramic-reinforced PEEK. Abutments were surface treated and bonded on the titanium base abutments with resin cement. Then, lithium disilicate crowns were bonded on the assigned abutments. Specimens were then subjected to dynamic loading for 1,200,000 cycles. The fracture strength (N) of the assembly was assessed using a universal testing machine. One-way ANOVA followed by multiple comparison tests was used to evaluate the effect of abutment material on the fracture strength of single implant-supported restorations at a significance of .05. The average fracture strength for the groups with zirconia, PEEK, and lithium disilicate two-piece abutments were 1362N ± 218N, 1235N ± 115N, and 1472N ± 171N, respectively. There was a significant (p < 0.05) difference in fracture strength among the groups. The lithium disilicate group had significantly higher fracture strength (p = 0.0058) than the group with PEEK; however, there was no significant (p > 0.05) difference between the other groups. Two-piece abutments restored with lithium disilicate crowns investigated in the study have the potential to withstand the average physiological occlusal forces in the anterior region.

Management of luxation injuries in line with International Association of Dental Traumatology guidelines – Two case reports

Luxation injuries represent significant traumatic events for permanent teeth. This article presents the management of intrusive and extrusive luxation injuries, following the International Association of Dental Traumatology (IADT) guidelines, through two case reports. The first case involves a 30-year-old female with an intruded maxillary left central incisor, managed through surgical extrusion, stabilization, and endodontic treatment. The second case features a 15-year-old female with an extruded maxillary left central incisor, repositioned and splinted. Follow-up examinations revealed the resolution of symptoms in both cases. These cases highlight the efficacy of IADT guidelines in diagnosing and treating luxation injuries, resulting in favorable outcomes.

Conservative management of lateral canal biofilm-related persistent intraoral sinus and other complications in traumatized, immature incisors: A case report with 30 months’ follow-up

Conservative or regenerative endodontic treatments are the preferred approaches for managing traumatized (vital or necrotic) immature permanent teeth in growing patients. Diagnosing pulp vitality preoperatively using sensitivity tests can be challenging, especially if multiple teeth are traumatized, potentially leading to the failure of the chosen endodontic treatment. Unexpected complications, such as persistent intraoral sinus related to the lateral canal (often not visible on conventional radiographs) and delayed periradicular bone healing, may also arise. This case report presents the successful conservative management of three traumatized incisors with such complications. A novel intracanal dressing method was used to treat a persistent intraoral sinus related to the lateral canal in the permanent maxillary left central incisor, which was unresponsive to traditional dressing materials and methods, thereby avoiding surgery or extraction. Additionally, delayed bone healing in response to revascularization treatment in the permanent maxillary right central incisor, and the initially involved vital permanent maxillary right lateral incisor, was addressed with re-revascularization and root canal treatment, respectively. This article discusses tailored management strategies and possible reasons for associated complications in traumatized teeth. It emphasizes the importance of high-quality radiographic images, pulp vitality tests based on blood oxygenation, understanding the presence of biofilm in lateral canals, modified dressing methods, appropriate dressing vehicles, and the necessity of patience in treating traumatic dental injuries. Keywords: Biofilm; Conservative Management; Pediatric Dentistry; Root Canal Medicaments; Teeth Injuries

Influence of Printing Angulation on the Accuracy (Trueness and Precision) of the Position of Implant Analogs in 3D Models: An In Vitro Pilot Study

Background: With CAD-CAM, dental models are often fabricated by additive manufacturing (AM) methods. Dental models for implant prostheses involve the manual placement of analogs, which could affect their final fit. Therefore, in this experimental in vitro study, the accuracy of the analogs’ position in models printed using AM methods was examined by comparing three different printing orientations. Methods: An STL file was obtained by scanning a master model with an implant placed in the maxillary left central incisor position. Three study groups (n = 10) with varying printing orientation parameters were obtained (0, 45, and 90 degrees). They were digitalized with a laboratory scanner and evaluated with an analysis metrology program. Differences between 3D datasets were measured using the RMS for trueness and SD RMS for precision. The data were statistically analyzed using the ANOVA test at a significance level of p &lt; 0.05, followed by the Bonferroni post hoc test. Results: The 45-degrees group showed the best results. Regarding trueness, statistically significant differences were found between the 45- and 90-degrees groups (p &lt; 0.005). In terms of precision, statistically significant differences appeared between the 45- and 0-degrees groups (p &lt; 0.011) and between the 45- and 90-degrees groups (0.003). Conclusions: The printing angulation parameter affects the accuracy of 3D-printed models. Implant models manufactured at 45 degrees of printing angulation are more accurate than those printed at 0 or 90 degrees.

A Comparative Study to Check the Accuracy of Tooth Shade Selection With Standardized Digital Photographs and a Spectrophotometer.

The success of any dental prosthesis depends on aesthetics and function. A proper shade selection is a prime requisite for providing aesthetics to dental patients. This study aims to compare the photographic method of shade selection with that of a digital spectrophotometer. The study included 50 participants. The primary inclusion criterion was the presence of the maxillary left central incisor without a history of restorative or endodontic procedures. The shade of the left maxillary central incisor was determined using the VITA Easyshade V spectrophotometer (VITA Zahnfabrik, BadSäckingen, Germany) and the digital photography method for all the selected participants. The CIELAB colour space utilizes three values (L*, a*, and b*) to objectively measure colour. While the digital photography approach used Adobe Photoshop software (Adobe Systems Incorporated, San Jose, CA) to report solely the L*, a*, and b* values, the spectrophotometer reported the L*, a*, and b* values along with the actual shade. After obtaining the values of L*, a*, and b*, ΔE, which is their difference, was calculated using a standard formula. Statistical analysis was carried out by using Student's t-test and proportion z-test. When the comparison of the L*a*b* values was done, Student's t-test showed similar (P>0.05) L(t=0.16, P=0.872), a (t=0.52, P=0.607), and b (t=0.23, P=0.820) values between the two groups; that is, they did not differ significantly or showed perfect matching. There was agreement (ΔE≤2) in 42 (84.0%) cases and disagreement (ΔE>2) in eight (16.0%) cases. The proportion z-test showed an agreement of 84.0%, which was statistically highly significant (z=20.44, P<0.001). The true shade of the teeth can be depicted using standardized digital images.

Surgical Management of Radicular Cyst with the Application of a Natural Platelet Concentrate and Ostoden: A Case Report

ABSTRACT The most frequent cystic lesions that affect the jaw are radicular cysts. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary central and lateral incisors, and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] along with Ostoden bone graft material used for postoperative healing. A 46-year-old male patient presented to the department with swelling in the palatal aspect of the maxillary anterior region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the left maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery, and PRF with Ostoden bone graft was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled at follow-ups after 7 days, 3, 6, and 9 months. No symptoms such as pain, inflammation, or discomfort were observed during the review period.

Multidisciplinary Treatment: Follow-Up of Dental Autotransplantation for 10 Years.

The objective is to present a clinical case of dental autotransplantation managed with surgery, orthodontics, endodontics, periodontics, and aesthetic rehabilitation. A 10-year-old boy sought treatment after avulsion of the maxillary left central incisor, which was not reimplanted. Based on anamnesis, clinical examination, and complementary examinations, agenesis of the maxillary and mandibular second premolars except the mandibular right second premolar was observed. After a multidisciplinary planning, the space in the maxillary left central incisor region was opened to receive the transplanted mandibular right second premolar. The receptor site was created in a single surgical procedure. Pulp necrosis was noted in the transplanted tooth, which was treated endodontically, and the agenesis spaces were closed using fixed orthodontic appliances. After removing the appliance, gingivectomy with osteotomy was performed in the maxillary right central incisor and the transplanted tooth regions to harmonize the height and shape of the gingival contour. Next, aesthetic readjustment was performed with tooth whitening, using office and home techniques, followed by microabrasion of the vestibular surface of the maxillary right central incisor. Direct composite resin restorations were placed in the maxillary incisors, and the teeth were rehabilitated using incisal and palatal guides. A multidisciplinary approach is essential for reestablishing the function and aesthetics of complex cases involving dental autotransplantation.