Orthodontic Space Management and Mandibular First Premolar Autotransplantation Following Traumatic Anterior Tooth Loss in a Child with Five-Year Clinical and Radiographic Follow-Up: A Case Report

Background/Objectives: The management of severe anterior dental trauma in growing patients remains a clinical challenge. This case report describes the treatment of a 10-year-old boy presenting with traumatic loss of maxillary anterior teeth following a road traffic accident, including avulsion of two permanent incisors and a primary canine, associated with luxation and intrusion of the contralateral central incisor. Methods: A multidisciplinary approach involving paediatric dentistry, orthodontics, oral surgery, and restorative dentistry was implemented. Treatment aimed to preserve the traumatised incisor and restore the anterior maxillary region through a biological approach combining mandibular first premolar autotransplantation and orthodontic space management. Results: The transplanted first mandibular premolar demonstrated favourable healing, with continued root development and a satisfactory crown-to-root ratio. After orthodontic treatment, the tooth was restored with a composite veneer, achieving good aesthetic and functional outcomes, maintained at the 5-year follow-up. Conclusions: This case highlights that autotransplantation combined with orthodontic space management may represent a viable treatment option in carefully selected growing patients, allowing preservation of alveolar bone, function, and aesthetics. Appropriate surgical, orthodontic, and restorative planning was crucial to the treatment’s success.