scholarly journals Multidisciplinary Management of a Fractured Premolar: A Case Report with Followup

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Madhavi R. Kondapuram Seshu ◽  
Christopher Leslie Gash

The general dental practitioner must consider orthodontic extrusion of a tooth when a subgingival defect, such as, crown fracture occurs before prosthetic rehabilitation, especially in the aesthetic zone. Extrusion enables the root portion to be elevated which exposes sound tooth structure for placement of restorative margins. This case report describes the multidisciplinary management of a fractured upper first premolar in a general dental practice. The forced orthodontic eruption is achieved by an endodontic attachment and sectional fixed appliance with an offset placed in the wire. The ability to extrude premolars with this method is complicated by heavy occlusal forces, occlusal interferences, and short clinical crown length. The tooth was restored with a titanium post, composite core, and porcelain fused to metal crown. The entire course of treatment was carried out under National Health Scheme, UK and as a part of vocational training. The 21 months followup showed no change in occlusal contacts or gingival level.

2012 ◽  
Vol 2 (1) ◽  
pp. 41-43
Author(s):  
Dashrath Kafle ◽  
Reetu Shrestha ◽  
Binam Sapkota ◽  
Nisha Acharya

Trauma to the aesthetic region of the mouth is very common. However the treatment of the traumatic injuries of the tooth depends upon various factors. Orthodontic extrusion of the fractured tooth is regularly practiced treatment modality. Orthodontic extrusion of such tooth is physiological, less invasive and long lasting. The extrusion of the tooth brings enough dental tissue to maintain the biological width and ferrule later into restorative/prosthetic phase. In this article we will report a case which was extruded 4mm after endodontic treatment and restored by crown.


2011 ◽  
Vol 1 (1) ◽  
pp. 60-62
Author(s):  
Sandhya Shrestha ◽  
Rabindra M Shrestha ◽  
Marisha Dahal

Post endodontic restoration in cases of grossly destructed teeth are difficult as the available tooth structure is less, margins are subgingival and of compromised prognosis because the restoration might encroach upon the periodontium affecting its status to deteriorate. Interdisciplinary approach using forced eruption or Orthodontic extrusion along with minimal surgical crown lengthening can give adequate supragingival tooth surface for proper restoration and protect its root support from getting violated. This is the case report of an unsalvageable tooth that is restored to satisfactory functional and esthetic restoration utilizing interdisciplinary approach.


2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2926-2931
Author(s):  
Deepika Masurkar ◽  
Priyanka Jaiswal ◽  
Diksha Agrawal

Crown lengthening is a surgical procedure designed to increase the extent of the supragingival tooth structure, so that the clinician can restore the tooth. Crown lengthening procedure is done to maintain normal biologic width and increase crown length for retention of prosthesis. Various techniques have been proposed to perform CLP, such as gingivectomy, undisplaced flap with or without osseous reduction, apically repositioned flap with or without bone reduction, and orthodontic forced eruption with or without fibrotomy. Selection of one of this CLP technique depends upon esthetics, clinical ratio of crown to root, structure of root, location of furcation, position of tooth and the capacity of the tooth to be restored. This case report illustrate two different methods of doing crown lengthening procedure the selection of case depends upon various soft tissue and hard tissue parameters. Owing to the various advantages, disadvantages and associated limitation with different methods, we opted for surgical CLP with scalpel method. Uneventful healing was observed in both our cases. No post-operative complications was observed in both cases. Thus to conclude success rate of CLP is high but appropriate selection of case is required. In our case report both the methods of CLP shows significant result in increasing the crown length and maintaining the biological width.


2014 ◽  
Vol 4 (2) ◽  
pp. 51-55
Author(s):  
Nisha Acharya ◽  
Praveen Singh Samant ◽  
Vanita Gautam ◽  
Ourvind Singh ◽  
Hemanta Halwai

The management of patients with traumatic injuries to their dentition poses a serious challenge in everyday general dental practice. For the rehabilitation of the complicated subgingival crown fracture of anterior teeth, multidisciplinary approach is often indicated. A combination of endodontic, orthodontic, periodontal and prosthodontic approach may be required. Orthodontic or periodontal intervention becomes an integral part for the exposure of the sound tooth structure of fractured anterior teeth with fracture line extending subgingivally. The aim of this paper is to discuss the immediate endodontic management followed by orthodontic extrusion of traumatized upper anterior teeth with fracture at the subgingival level. In order to expose the sound tooth structure for prosthodonticintervention, orthodontic extrusion was performed after endodontic treatment. To avoid extraction of the involved teeth, the multidisciplinary approach was adopted and finally the teeth were restored prosthodontically. The final result was esthetically pleasant and periodontically sound. 


2012 ◽  
Vol 6 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Amir Reza Rokn ◽  
Anna Saffarpour ◽  
Rouzbeh Sadrimanesh ◽  
Kaveh Iranparvar ◽  
Aida Saffarpour ◽  
...  

Background: Loss of bone and soft tissue attachment are common sequelae of periodontitis that may jeopardize the aesthetic outcome and compromise the functional and aesthetic outcomes of treatment. The following case report describes one of the most predictable techniques of vertical ridge augmentation, which is orthodontic extrusion or forced eruption of hopeless teeth. Method: A 34-year-old woman who presented with severe attachment loss and deep pockets was diagnosed with generalized aggressive periodontitis. The mobile maxillary incisors were consequently extracted and were replaced with dental implants. However, prior to extraction, orthodontic extrusion of the hopeless incisors was performed to correct vertical ridge defects. Following extrusion and extraction of the maxillary incisors, to prevent soft tissue collapse and to preserve the papillae during socket healing, the crowns of the extracted teeth were used as pontics on a removable partial provisional denture. After 8 weeks, the implants were placed, and an immediate functional restoration was delivered. After 4 months of healing, a fixed definitive partial prosthesis was fabricated and delivered. Result: After periodontal treatment, over a 2-year period, the progression of aggressive periodontitis was controlled. The mean vertical movement of marginal bone was 3.6 mm. The use of the crowns of extracted teeth appears to be an effective method to maintain papillae. Conclusions: Orthodontic extrusion is a predictable method for the correction of vertical ridge defects. Orthodontic treatment does not aggravate or hasten the progression of aggressive periodontitis.


2018 ◽  
Vol 12 (1) ◽  
pp. 238-245 ◽  
Author(s):  
Rakesh. R. Rajan ◽  
Sapna Chandira Muddappa ◽  
Priya Rajendran ◽  
Ashok Sukumaran Nair

Introduction: Fracture of tooth structure at or below the gingival margin compromises rehabilitation and hampers esthetics and function. Management: Management of such cases by a post-core and crown restoration, or periodontal surgery or orthodontic extrusion alone may not always suffice in attaining a good result. Case Report: A multi-disciplinary approach which includes all of the above mentioned procedures helps in long term success. Conclusion: Careful case evaluation, treatment planning and meticulous attention to detail are the keys to the best treatment outcome.


2018 ◽  
Vol 06 (01) ◽  
pp. 037-039
Author(s):  
Suruchi Jatol-Tekade ◽  
Satyajit Tekade ◽  
Kush Pathak ◽  
Vishal Patni

AbstractLoss of tooth structure in the esthetic region is a big challenge for restorative dentist as it not only involves the establishment of tooth structure but also complies microesthetics. If the tooth structure is lost near the gingival margin, then the periodontal aspect cannot be overlooked. Surgical crown lengthening and orthodontic extrusion of the remaining tooth structure are two possible treatment modalities for such cases. Which one is best suited depends on the indications for each procedure. This study reports an orthodontic extrusion for the restoration of fractured upper canine. Preference of crown lengthening by orthodontic extrusion over surgical crown lengthening is clarified along the case discussion.


2020 ◽  
Vol 23 (2) ◽  
pp. 28-33
Author(s):  
Indira Apriantika ◽  
Agung Krismariono

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.


2020 ◽  
Vol 12 (45) ◽  
pp. 24-33
Author(s):  
Fábio Shiniti Mizutani ◽  
Atila de Freitas ◽  
Adriano Sapata ◽  
Claudio Sato

Keeping in mind the final result is the basis of any type of treatment, especially those in which the morphology, size and proportion of the anterior teeth will be changed. This is where a good treatment plan based on a diagnostic wax-up tested with a mock-up and approved by the patient becomes crucial. This case report aims to exemplify how to transfer the diagnostic information to the patient’s mouth and direct it not only to the restorative dentistry, but also to the surgeon when performing the crown length. Diagnostic waxing was performed by the laboratory technician, obeying anterior posterior incisal and gingival criteria and curvatures, which were transported to an aesthetic guide through mock up to mark the surgical points. Then, surgery to increase the clinical crown with bone access and after healing, direct venners in composite resin also guided by waxing. In conclusion, a workflow can be established using the wax-up / mock-up that serves as a guide for the periodontist in the approach to surgical lengthening of the crown and for the rehabilitator who uses it to produce changes in the shape of dental dimensions .


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