To test temporary anchorage device (TAD) supported provisional crown as a stable fixed non-permanent solution to the esthetic/functional problem generated by early tooth loss in a growing patient.
Case Presentation
10 years old female presents after bike trauma with a chief complaint of avulsion of upper right central incisor and root fracture of middle third of left central incisor. Since neighboring teeth to the edentulous area were also affected, traditional fixed prosthetic treatments such as Maryland Bridge were discarded. Parents strongly requested a fixed alternative. It was suggested to use a TAD crown as a fixed non definite solution to esthetic problem.
The objective was to avoid a definite solution at this time since growth was not finished and therefore a submerge implant scenario was likely to happen in the future if a definitive solution was provided at this point in development. Another idea was to avoid bone resorption in the edentulous area which would generate difficulties in periodontal preservation of the future implant site.
A thorough cbct evaluation of the bone was performed. It was used for TAD selection as well as placement with surgical guide prepared with digital 3D planning. Immediate load with acrylic provisional was placed. Initial stability proved to be adequate immediately after the procedure as well as seven months later.
Discussion and summary
TADs can provide the growing patient with an esthetic, functional and comfortable treatment alternative for provisional fixed restauration. This temporary therapy can also contribute to bone preservation for future implant placement.