A dentist, father, old car enthusiast, education advocate, photographer and some more. My cases shown on Dental Soul can be used in your study club or classroom discussions only if they are shown as web pages from Dental Soul.
When there is a fractured tooth, there are several options such as, crown lengthening, orthodontic extrusion and surgical extrusion. Surgical extrusion is partial extraction of a fractured tooth. The fractured tooth luxated and left in the socket at a more coronal position. Orthodontic extrusion takes time. Crown lengthening removes the supporting bone and may compromise the esthetics. A fractured tooth that had endodontic treatment done many years ago may not be suitable for surgical extrusion because it may fracture even more when surgical extrusion is attempted.
This case shows a surgical extrusion in a lady in her mid 60’s. After anesthesia, a periotome was used to carefully sever the periodontal ligaments. When the tooth was luxated and moved into the desired position, a figure eight suture was done to stabilize it. Just like stabilizing a replanted tooth, there is no need to fix the tooth to adjacent teeth with resin and wire.
Tooth #7 is fractured.
Figure 8 suture.
Enough tooth exposed for ferrule effect.
After the surgical extrusion of #7.
Of course the tooth needs to be endodontically treated once it stabilizes. Then a post, core and a crown will be needed.
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Nice work. What do think about the timing of endodontic treatment? Before or after? If after, how long do you think you need to wait before the endo treatment is initated?
Thanks, Gene.
I think endo can be done after the extrusion.
Once the tooth becomes more solid, in a few weeks, endo can be done.
Share some of your cases, please.
Anyone can share his/her cases.
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What about root resorption?
Is it a common occurence with a case like this?
Root resorption is minimal if you keep the PDL’s alive. I usually keep the root inside the socket. Never take it out of the socket unless you are suspecting a root tip fracture.
If you have to take the tooth completely out of the socket for inspection, place it back in the socket immediately after you are done with the inspection.
Thanks…
I think I will try it next time I come across a case like yours.
Thanks for sharing your case.