Preservation of an Inverted Ectopic Maxillary Central Incisor Adjacent to an Alveolar Cleft by Replantation With Axial Correction and Orthodontic Alignment

Management of an inverted ectopic maxillary central incisor adjacent to an alveolar cleft is challenging because spontaneous eruption into the dental arch is impossible. In a male patient with unilateral cleft lip and alveolus treated between 5 years 4 months and 12 years 5 months, the incisor was replanted with axial correction and mucosal coverage after secondary alveolar bone grafting and confirmation of bony bridging. Surgical exposure and orthodontic traction guided the tooth into the arch without infection, clinically significant root resorption, or clinical ankylosis. This case illustrates replantation followed by surgical exposure and orthodontic traction as a tooth-preservation option.