**Question:** A 12-year-old girl was hit in the face by an errant softball pitch while batting and has had her mandibular incisors knocked out. Which of the following represents the best plan of action?

A. Provisional restoration
B. Tooth extraction and replacement with fixed prosthesis
C. Tooth extraction and immediate placement of an implant
D. Tooth extraction and subsequent orthodontic treatment

**Correct Answer:** C. Tooth extraction and immediate placement of an implant

**Core Concept:**

Following the traumatic loss of mandibular incisors, the best plan of action addresses both the immediate restoration of function and long-term stability of the dental arch. In this situation, the most suitable option combines immediate tooth extraction, followed by immediate implant placement to preserve the alveolar bone and soft tissue for future prosthetic restoration.

**Why the Correct Answer is Right:**

Option C recommends a combination of tooth extraction and immediate implant placement due to the following reasons:

1. **Immediate implant placement:** This approach ensures the preservation of the alveolar bone and soft tissue, which are crucial for successful long-term prosthetic restoration. Immediate implant placement prevents alveolar bone resorption and maintains the gingival architecture, enhancing the future prosthetic outcome.

2. **Immediate prosthetic restoration:** Immediate placement of a provisional restoration allows the patient to regain functional occlusion and esthetics, improving the patient's quality of life in the short term.

**Why Each Wrong Option is Incorrect:**

A. **Provisional restoration:** Although a provisional restoration provides temporary function, it does not address the long-term stability of the dental arch and may lead to further complications in the future.

B. **Tooth extraction and replacement with fixed prosthesis:** Removing the tooth and replacing it with a prosthesis might lead to alveolar bone resorption, affecting the future implant placement and prosthetic outcome.

D. **Tooth extraction and subsequent orthodontic treatment:** Extracting a tooth and requiring orthodontic treatment before placing an implant may lead to additional morbidity and a prolonged treatment duration, resulting in a less optimal outcome compared to the correct option (C).

**Clinical Pearl:**

In cases of traumatic tooth loss, immediate implant placement in conjunction with a provisional restoration ensures optimal treatment outcomes by preserving the alveolar bone and soft tissue, addressing both immediate function and long-term stability, and minimizing future complications. This approach maintains the integrity of the dental arch, ensuring a more predictable and successful treatment plan.