Aesthetic and custom-made interim space maintainers

Avulsion of permanent teeth represents 0.5−16% of all dental injuries in children,¹ with maxillary incisors being the most commonly avulsed tooth. Immediate treatment of choice for an avulsed permanent tooth is usually replantation, which aims to preserve the pulp and the periodontal tissues. However, success of replantation is dependent on the extra-oral dry time, which dictates the survival of the periodontal ligament (PDL) cells. After 30 minutes of extra-oral dry time, most PDL cells are non-viable.² Replacement resorption is an expected outcome when the extra-oral dry time is over 60 minutes,³ resulting in poor long-term prognosis and eventual extraction of the tooth at a young age. Thus, aesthetic space maintainers are often essential in the interim phase to preserve arch length, as well as aesthetics, until the time is right for a permanent replacement. Traditional methods involve using acrylic teeth as a pontic in either a fixed or removal space maintainer. We present a case, where an alternative technique was used to make a more aesthetic and reliable alternative.