Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.22
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2015, vol. 52, nr 3, July-September, p. 371–376

Publication type: clinical case

Language: English

Creative Commons BY-NC-ND 3.0 Open Access

Forced Eruption in the Management of Subgingival Crown Fracture – an Interdisciplinary Approach: Case Reports

Ekstruzja ortodontyczna w przypadkach poddziąsłowych złamań korzenia – leczenie interdyscyplinarne: opisy przypadków

Sajid Ali1,A, Asma Zoya1,D, Fehmi Mian1,A

1 Department of Conservative Dentistry & Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India


Traumatic fracture of the maxillary incisors and its sequelae impair the esthetics, function and phonetics. For a clinician, on the other hand, they pose a challenge for the establishment and accomplishment of an adequate treatment plan. A subgingival fracture line may involve biologic width resulting in restorative difficulties, where preservation of healthy attachment apparatus becomes paramount for a successful outcome. Among all the treatment options, such as periodontal crown lengthening, surgical extrusion, intentional replantation and extraction, orthodontic extrusion is the most conservative method. The aim is to obtain both a sound tooth margin which offers adequate crown ferrule and a sustained biologic width by bringing the periodontal apparatus along with it. The cases presented in this report describe an interdisciplinary approach involving orthodontic extrusion, conservative periodontal surgery, and cast post and core with porcelain-metal crown prostheses. This study concludes that a multidisciplinary treatment approach with cooperation among specialists to manage such a type of dental injury is essential for favorable esthetic and functional rehabilitation.

Key words

subgingival fracture, orthodontic extrusion, cast post and core

Słowa kluczowe

złamanie poddziąsłowe, ekstruzja ortodontyczna, wkład koronowo-korzeniowy

References (17)

  1. Andreasen J.O., Andreasen F.M., Tsukiboshi M.: Crown-root fractures. [In:] Textbook and Color Atlas of Traumatic Injuries to the Teeth. Eds.: Andreasen J.O., Andreasen F.M., Andersson L., Blackwell Munksgaard, Copenhagen 2007, 1st ed., 314–336.
  2. Tapias M.A., Jimenez-Garcia R., Lamas F., Gil A.A.: Prevalence of traumatic crown fractures to permanent incisors in a childhood population: Mostoles, Spain. Dent. Traumat. 2003, 19, 119–122.
  3. Cortes M.I., Marcenes W., Sheiham A.: Impact of traumatic injuries to the permanent teeth on the oral healthrelated quality of life in 12–14-year-old children. Community Dent. Oral Epidemiol. 2002, 30, 193–198.
  4. Olsburgh S., Jacoby T., Krejci I.: Crown fracture in the permanent dentition: Pulpal and restorative considerations. Dent. Traumatol. 2002, 18, 103–115.
  5. Poi W.R., Cardoso Lde C., de Castro J.C., Cintra L.T., Gulinelli J.L., de Lazari J.A.: Multidisciplinary treatment approach for crown fracture and crown-root fractured – a case report. Dent. Traumatol. 2007, 23, 51–55.
  6. De Castro M.A., Poi W.R., de Castro J.C., Panzarini S.R., Sonoda C.K.: Crown and crown-root fractures: an evaluation of the treatment plans for management proposed by 154 specialists in restorative dentistry. Dent. Traumatol. 2010, 26, 236–242.
  7. Villat C., Machtou P., Naulin-Ifi C.: Multidisciplinary approach to the immediate esthetic repair and longterm treatment of an oblique crown-root fracture. Dent. Traumatol. 2004, 20, 56–60.
  8. Bach N., Baylard J.F., Voyer R.: Orthodontic extrusion: periodontal considerations and applications. J. Can. Dent. Assoc. 2004, 70, 775–780.
  9. Minsk L.: Orthodontic tooth extrusion as an adjunct to periodontal therapy. Compend. Contin. Educ. Dent. 2000, 21, 768–774.
  10. Bach N., Baylard J.F., Voyer R.: Orthodontic extrusion: periodontal considerations and applications. J. Can. Dent. Assoc. 2004, 70, 775–780.
  11. Benenati F.W., Simon J.H.S.: Orthodontic root extrusion: its rationale and uses. Gent. Dent. 1986, 34, 285–289.
  12. Heithersay G.S.: Combined endodontic-orthodontic treatment of transverse root fractures in the region of the alveolar crest. Oral Surg. Oral Med. Oral Pathol. 1973, 36, 404–415.
  13. Brown G.J., Welbury R.R.: Root extrusion, a practical solution in complicated crown-root incisor fractures. Br. Dent. J. 2000, 189, 477–478.
  14. Proffit W.R., Fields H.W., Sarver D.M.: Contemporary orthodontics. Mosby, St. Louis 2007, 4th ed., 312–313.
  15. Malmgren O., Malmgren B., Frykholm A.: Rapid orthodontic extrusion of crown root and cervical root fractured teeth. Endod. Dent. Traumatol. 1991, 7, 49–54.
  16. Sorensen J.A., Engelman M.J.: Ferrule design and fracture resistance of endodontically treated teeth. J. Prosthet. Dent. 1990, 63, 529–536.
  17. Marchi G.M., Mitsui F.H., Cavalcanti A.N.: Effect of remaining dentine structure and thermal-mechanical aging on the fracture resistance of bovine roots with different post and core systems. Int. Endod. J. 2008, 41, 969–976.