Orthodontic treatment of mandibular agenesis with maxillary premolar autotransplantation

This case report describes an 8-year-old girl with agenesis of 2 mandibular second premolars, 2 mandibular central incisors, and all third molars. To compensate for the absence of mandibular teeth, the 2 developing maxillary second premolars were autotransplanted into the sites of the missing mandibular second premolars. Radiographs confirmed good transplant attachment, pulp obliteration, and no signs of hemorrhage or edema. Vitality testing yielded a positive result. Fifteen months after autotransplantation, once complete permanent dentition was established, multibracket orthodontic treatment was initiated at the age of 11 years, 8 months. The active treatment lasted 26 months, during which correct overjet and overbite relationships were achieved. This case report highlights autotransplantation as a conservative and effective treatment option for young patients with multiple agenesis.