I. Introduction
A crown-root fracture extending below the gingival attachment often requires a multidisciplinary approach due to its difficulties in restoration. Failure to place the crown margins on sound tooth may violate the biologic width, and should be considered a restorative failure. Orthodontic or surgical extrusion of such teeth allows elevating the fracture line above the epithelial attachment and so the proper finishing margins can be prepared. This case report shows a management of teeth with crown-root fracture using orthodontic extrusion.
II. Case Presentation
< Case 1 >
1. Age/sex : 12 / F
2. Chief Complaint (C.C) : Tooth fracture of #11 by trauma
3. Past Trauma History : N-S
4. Present Illness (P.I) : Complicated crown-root fracture of #11 (with pulp exposure)
5. Impression : Complicated crown-root fracture
6. Tx Plan : #11 - RCT, Orthodontic extrusion using arch wire & J hook, Post & Core, All Ceramic Cr
< Case 2 >
1. Age/sex : 19 / M
2. Chief Complaint (C.C) : Tooth fracture of #11, 12, 21, 22 by trauma
3. Past Trauma History : N-S
4. Present Illness (P.I) : Complicated crown-root fracture of #21, 22 (with pulp exposure)
Crown fracture of #11, 12 (without pulp exposure)
5. Impression : Complicated crown-root fracture, Crown fracture
6. Tx Plan : #21, 22 - RCT, Orthodontic extrusion using arch wire & J hook, Post & Core, All Ceramic Cr.
#11, 12 - Composite resin restoration
III. Conclusion
Orthodontic extrusion provides a favorable alternative to extraction or periodontal surgery(CLP) on the subgingivally fractured tooth. The placement of final restoration after orthodontic extrusion resulted in good esthetics and periodontal health postoperatively. In this case, it was possible to re-establish the biological width and achieve esthetic results through orthodontic extrusion.
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