The anterior maxilla is the primary site for an avulsion. Upto 8 percent of injuries result in a situation where a tooth cannot be reimplanted or a reimplanted tooth is eventually lost. Under such circumstances a clinician has various removable and fixed prosthetic options. One option often overlooked is the option to transplant a premolar to replace the avulsed tooth. Extensive studies show that the most decisive factor for successful tooth transplantation is the stage of root development when the root is nearly 3/4 formed. It is at this point that the tooth has the greatest ability to reconnect vital nerve and blood endings. If properly transplanted during this stage, a tooth has upwards of a 90 percent long term success rate. There are many advantages to a successful transplantation over other viable options. A tooth transplant has a bone inducing capacity that can rebuild lost labial bone. The procedure can be performed at a very young age in comparision to other procedures (10 - 12). A transplanted tooth can also be moved orthodontically. Contraindications for this procedure would include improper stage of premolar root formation. This procedure is also not considered a first choice treatment if the rest of the dentition is in proper occlusion. In order to carry out the transplantation the clinician must be familiar with specific techniques to avoid trauma to the pdl and root surface.
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