Orthodontic extrusion--a new simplified aesthetic technique

Abstract

Various techniques have been described to extrude the roots of fractured teeth to facilitate prosthetic restoration. Many of these have the disadvantage of poor aesthetics, they require skill in fabrication and fitting, and there is often inadequate control over the amount of extrusion. With the technique described, root canal therapy is completed initially and a cast gold post is cemented into the root canal. The post has a channel extending from the labial to the palatal aspect. A temporary acrylic crown is fitted to restore aesthetics, and the channel is extended though the palatal and labial surfaces. An orthodontic wire framework with a horizontal strut at the level of the original incisal edge of the fractured tooth is then bonded to the adjacent abutment teeth. The amount of extrusion required is estimated and a corresponding reduction is made in the length of the acrylic temporary crown. An elastic threaded through the channel and looped over the horizontal strut of the framework provides the extrusive force. A 6 week retention period is required following the extrusion. Periodontal surgery is then carried out if necessary, and a new provisional crown is placed. The final porcelain restoration is fitted after 6 months.