Tooth avulsion: mini-implant rehabilitation in growing patients.

PRESENTING PROBLEM: The incidence of dental avulsion varies from 0.5 to 16% for permanent teeth and from 7 to 13% in deciduous teeth.The most affected age bracket is between 9 and 10 years, the period in which greatest craniofacial growth and development takes place.This causes considerable complexity in trauma management, as the therapeutic choice must suit this process without hindering it.Literature puts forward a number of different therapeutic possibilities such as Maryland Bridge, Removable Partial Denture, Orthodontic Space Closure and Autogenous Tooth Transplantation, all of which are valid from a functional and aesthetic point of view but that have an adverse effect on quality of life. Osteoingetrated implantation is not considered as an option as although no minimum age limit is established in literature for this type of rehabilitation, it causes ankylosis of the implant with consequent infraocclusion and therefore aesthetic and functional deficit.CLINICAL MANAGEMENT:This study aims to evaluate the effectiveness of a therapeutic approach through the use of mini-implants and immediate load implants.It presents two clinical cases of growing patients:ML aged 10, with avulsed 11 and 21, and KJ aged 14, with avulsed 11 and 12.Follow-up was performed at 3-6-12 and 24 months.DISCUSSION:The proposed technique made it possible to obtain rehabilitation of the traumatised frontal section in a single session, with immediate high aesthetic and functional success, and high patient satisfaction.Careful pre-operative study made it possible to plan surgery so as to not hinder the cranial-facial growth in process.The results at 24 months seem to confirm the initial assumption although further studies and follow-up will be required