Treatment of Child with Four Lost Maxillary Incisors due to Traffic Injury.

Tooth injury is frequently encountered in pediatric clinical practice. A clinician may be requested to not only respond at the time of injury, but also properly diagnose how such injury will affect the teeth and dentition. Here, we present a case of a child who lost 4 bilateral maxillary incisors due to a traffic accident, and in whom marked mesial inclination of the bilateral maxillary canines and bilateral maxillary first premolars would subsequently occur. Dental management was provided over an extended period. The boy, aged 9 years 11 months, visited our department with the chief complaint of premature loss of 4 bilateral maxillary incisors and eating disturbance associated with the loss of these teeth. Initially, a denture was fitted. The bilateral maxillary canines subsequently demonstrated marked mesial inclination, however, and erupted from an area equivalent to that of the bilateral central incisors. The bilateral maxillary first premolars also showed mesial inclination and rotation. Taking esthetics into consideration, a Nance holding arch with resin buttons that extended to the maxillary incisors and attached to artificial teeth was used. This appliance was also equipped with a retracting hook, and the bilateral maxillary canines were moved downward and distally. Presently, the removable partial denture is worn for the purposes of retention, esthetics, and mastication. Long-term oral management will be necessary. Therefore, final prosthetic treatment for the missing maxillary incisors is planned for when the patient reaches adulthood.