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VOLUME 4 , ISSUE 1 ( January-June, 2019 ) > List of Articles

CASE REPORT

Multidisciplinary Management of Anterior Traumatized Tooth: A Case Report

Emi George, Rakhi P Veedu, Merin Joseph

Keywords : Cast post and core, Orthodontic extrusion, Sub-gingival fracture

Citation Information : George E, Veedu RP, Joseph M. Multidisciplinary Management of Anterior Traumatized Tooth: A Case Report. Cons Dent Endod J 2019; 4 (1):18-20.

DOI: 10.5005/jp-journals-10048-0043

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Background: Traumatized anterior teeth with subgingival crown-root fractures are a challenge to treat. Treatment of crown-root fractures often requires a multidisciplinary approach. Gingivectomy of the affected tooth can violate gingival contour of the tooth so orthodontic extrusion is a conservative procedure that allows extrusion of a tooth without any bone loss. Case description: This case report details the multidisciplinary management of the traumatized anterior tooth including endodontic treatment, orthodontic extrusion, and post-core-crown procedure to restore a right maxillary central incisor to achieve a satisfactory cosmetic result. The fractured fragment was removed and pulp tissue extirpation was done in 11. Obturation was completed at next appointment. The fracture line was extended subgingivally, so orthodontic extrusion was planned. After 8 weeks, the tooth had extruded around 2 mm of palatal tooth structure sufficient to provide a ferrule of 1 mm. A cast post and core was prepared, and a definitive metal-ceramic crown was placed over 11. The patient was reviewed for 6 months and 1 year. Conclusion: Management of cervical third fracture has various treatment options. Orthodontic extrusion is a conservative procedure that allows retention of a tooth without any bone loss. Cast post and core can adapt to the canal and strengthen the tooth. It can be considered as a conservative treatment option.


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  1. Mittal R, Gupta S. Managing sub-gingival fracture by multi-disciplinary approach: endodontics-forced orthodontic extrusion and prosthetic rehabilitation. Saudi Endod J 2013;3:2.
  2. Fournier A. Orthodontic management of subgingivally fractured teeth. J Clin Orthod 1981;15:502–503.
  3. Welbury R, Kinirons MJ, et al. Outcomes for root-fractured permanent incisors: a retrospective study. Pediatr Dent 2002;24:98–102.
  4. Potashnick SR, Rosenberg ES. Forced eruption: principles in periodontics and restorative dentistry. J Prosthet Dent 1982;48:141–148. DOI: 10.1016/0022-3913(82)90100-7.
  5. Johnson RH. Lengthening clinical crowns. J Am Dent Assoc 1990;121:473–476. DOI: 10.14219/jada.archive.1990.0207.
  6. Ulusoy AT, Tunc ES, et al. Multidisciplinary treatment of a subgingivally fractured tooth with indirect composite restoration: a case report. J Dent Child 2012;79(2):79–83.
  7. Fidel SR, Fidel-Junior RA, et al. Clinical management of a complicated crown-root fracture: a case report. Braz Dent J 2011;22:258–262.
  8. Simon JH, Lythgoe JB, et al. Clinical and histologic evaluation of extruded endodontically treated teeth in dogs. Oral Surg Oral Med Oral Pathol 1980;50:361–371. DOI: 10.1016/0030-4220(80)90422-3.
  9. Ivey DW, Calhoun RL, et al. Orthodontic extrusion: its use in restorative dentistry. J Prosthet Dent 1980;43:401–407. DOI: 10.1016/0022-3913(80)90209-7.
  10. Gómez-Polo M, Llidó B, et al. A 10 year retrospective study of the survival rate of teeth restored with metal prefabricated posts vs cast metal posts and core. J Dent 2010;38(11):916–920. DOI: 10.1016/j.jdent.2010.08.006.
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