A simple coustomized stainless steel wire framework for forced orthodontic extrusion

The management of traumatic injuries to patient’s dentition is an integral part of the general dental practice. One of the most important challenges for dentists is the recovery of extensive destroyed teeth. A multi-disciplinary approach is required in Treatment of crown fractures. However, crown-root fractures with fracture line below the gingival attachment or alveolar bone crest present restorative difficulties. In this case report we have presented a 22-year-old male who reported with fractured upper right central incisor following trauma. On clinical examination, it was observed that the upper right lateral incisor had a horizontal fracture at the junction of middle and cervical one-third level. The traumatized teeth treated endodontically, and then referred to our department to increase the crown height by orthodontic extrusion before permanent restoration. A long term follow up revealed that a multidisciplinary approach including: endodontic therapy, surgical crown lengthening or/and orthodontic extrusion followed by rehabilitation prosthesis could lead to long survival rate even for "hopeless" teeth. These procedures have the aim to expose a good amount of healthy tooth tissues that is fundamental to obtain a ferrule effect for the subsequent prosthetic restoration. Forced orthodontic extrusion is a technique in which difficult endodontic cases can be handled by the clinicians. In order to achieve desired results patients cooperation is necessary in spite of this being an easy technique.