Atypical extraction treatment for failing replanted maxillary and mandibular incisors with space closure of 2 mandibular incisors in the same quadrant.

We report the successful orthodontic treatment of a 13-year-old girl who had been involved in an accident with avulsion of her maxillary right central incisor and both mandibular left incisors. Fifteen months after replantation of the teeth, all showed severe root resorption with apical inflammation and had to be extracted. After compensatory removal of the maxillary left central incisor, all 4 extraction sites were closed within 20 months of active orthodontic treatment to avoid implant-prosthodontic replacement. By sequential extraction of the 2 hopeless replanted equilateral mandibular left incisors and common-sense management of straightwire mechanics, it was possible to move the right central incisor across the mandibular midline and close the large space completely. To our knowledge, no case report about orthodontic closure of 2 adjacent extraction spaces in the same quadrant has been published.