IADR Abstract Archives
Orthodontic Extrusion to Restore an Esthetically Compromised Central Incisor
Objectives: To present the management of an endodontically treated central incisor with a compromised esthetic situation due to the presence of a metal-ceramic crown impinging the supracrestal tissue attachment.
Methods: A 41-year-old female patient came to the University clinic concerned about the esthetic appearance of the metal-ceramic crown in tooth 1.1. She had received previous orthodontic treatment and an over-contoured crown impinging the supracrestal tissue attachment. A multidisciplinary management was planned with different treatment phases. In the same visit the old crown and a metal post were removed. The canal root retreatment was performed (Protaper Universal, Dentsply Maillefer) and a thermoplastic obturation (System B, SybronEndo) of the apical third was carried out. Also, a fiberglass post (Relyx Fiber Post, 3M ESPE) was adhesively luted (RelyX Unicem, 3M ESPE). After core build-up with resin composite, a bis-acrylic temporary crown (Protemp 3 Garant, 3M ESPE) was cemented. In the following visit, an acrylic resin temporary crown was definitively luted with a resin modified glass ionomer (Ketac-cem Plus, 3M ESPE). An orthodontic extrusion was performed after a circumferential supracrestal fiberotomy in order to increase the ferrule and improve the periodontal status. Once the required amount of extrusion was achieved an intermediate tooth stabilization was performed to allow for a complete maturation of bone. The final prosthetic restoration consisted in a monolithic zirconia (Lava TM Plus, 3M ESPE) crown luted with a self-adhesive resin cement (RelyX Unicem 2, 3M ESPE).
Results: After 10-year follow-up, the periodontal tissues were healthy and stable, and the patient was satisfied with the esthetic result. The clinical success of complex cases depends on an adequate planning, a multidisciplinary approach, together a deep knowledge of the available materials.
Conclusions: Orthodontic extrusion is a minimally invasive treatment that allows to manage complex multidisciplinary cases of severely compromised teeth.
Methods: A 41-year-old female patient came to the University clinic concerned about the esthetic appearance of the metal-ceramic crown in tooth 1.1. She had received previous orthodontic treatment and an over-contoured crown impinging the supracrestal tissue attachment. A multidisciplinary management was planned with different treatment phases. In the same visit the old crown and a metal post were removed. The canal root retreatment was performed (Protaper Universal, Dentsply Maillefer) and a thermoplastic obturation (System B, SybronEndo) of the apical third was carried out. Also, a fiberglass post (Relyx Fiber Post, 3M ESPE) was adhesively luted (RelyX Unicem, 3M ESPE). After core build-up with resin composite, a bis-acrylic temporary crown (Protemp 3 Garant, 3M ESPE) was cemented. In the following visit, an acrylic resin temporary crown was definitively luted with a resin modified glass ionomer (Ketac-cem Plus, 3M ESPE). An orthodontic extrusion was performed after a circumferential supracrestal fiberotomy in order to increase the ferrule and improve the periodontal status. Once the required amount of extrusion was achieved an intermediate tooth stabilization was performed to allow for a complete maturation of bone. The final prosthetic restoration consisted in a monolithic zirconia (Lava TM Plus, 3M ESPE) crown luted with a self-adhesive resin cement (RelyX Unicem 2, 3M ESPE).
Results: After 10-year follow-up, the periodontal tissues were healthy and stable, and the patient was satisfied with the esthetic result. The clinical success of complex cases depends on an adequate planning, a multidisciplinary approach, together a deep knowledge of the available materials.
Conclusions: Orthodontic extrusion is a minimally invasive treatment that allows to manage complex multidisciplinary cases of severely compromised teeth.