Journal of Prosthetic Dentistry

Surgical extrusion to provide a ferrule for restoring a tooth with a compromised prognosis: A clinical report

  • Iuliana Babiuc
    Corresponding author: Dr Iuliana Babiuc, Department of Removable Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu St, Bucharest 020021, ROMANIA
    Assistant Professor, Department of Removable Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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  • Mihaela-Rodica Păuna
    Professor, Department of Removable Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Published:November 07, 2020DOI:


      A surgical extrusion technique was used to provide a ferrule for a tooth with significant tooth structure loss and an oblique coronal fracture. The maxillary lateral incisor was surgically repositioned coronally to provide sufficient dentinal wall for a good prognosis of the restorative treatment. The procedure is conservative and relatively straightforward and can be performed rapidly with minimal patient discomfort.
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      1. The glossary of prosthodontic terms. Ninth edition.
        J Prosthet Dent. 2017; 117: e1-e105
        • Mamoun J.S.
        On the ferrule effect and the biomechanical stability of teeth restored with cores, posts and crowns.
        Eur J Dent. 2014; 8: 281-288
        • Jutkowitz A.
        • Samet N.
        Rethinking ferrule: a new approach to an old dilemma.
        Brit Dent J. 2010; 209: 25-53
        • Haralur S.B.
        • Alayani A.F.
        • Almutiq M.A.
        • Alfaifi A.A.
        • Al-Shehri A.A.
        Effect of inadequate ferrule segment location on fracture resistance of endodontically treated teeth.
        Indian J Dent Res. 2018; 29: 206-211
        • Meng Q.
        • Ma Q.
        • Wang T.
        • Chen Y.
        An in vitro study evaluating the effect of ferrule design on the fracture resistance of endodontically treated mandibular premolars after simulated crown lenghtening or forced erruption methods.
        BMC Oral Health. 2018; 18: 83
        • Simon J.H.
        • Kelly W.H.
        • Gordon D.G.
        • Ericksen G.W.
        Extrusion of endodontically treated teeth.
        J Am Dent Assoc. 1978; 97: 17-23
        • Scholtes E.
        • Suttorp C.M.
        • Loomans B.A.
        • Van Elsas P.
        • Schols J.G.
        Combined orthodontic, surgical and restorative approach to treat a complicated crown-root fracture in a maxillary central incisor.
        Am J Orthod Dentofacial Orthop. 2018; 154: 570-582
        • Vâlceanu A.S.
        • Stratul S.I.
        Multidisciplinary approach of complicated crown fractures of both superior central incisors: a case report.
        Dent Traumatol. 2008; 24: 482-486
        • Das B.
        • Muthu M.S.
        Surgical extrusion as a treatment option for crown–root fracture in permanent anterior teeth: a systematic review.
        Dent Traumatol. 2013; 29: 423-431
        • Argueta J.
        • Orellana A.
        • Plotino G.
        Surgical extrusion: a reliable technique for saving compromised teeth. A 5-years follow-up case report.
        G Ital Endodonzia. 2018; 32: 25-30
        • Dietrich T.
        • Krug R.
        • Krastl G.
        • Tomson P.
        Restoring the unrestorable! Developing coronal tooth tissue with minimally invasive surgical extrusion technique.
        Brit Dent J. 2019; 226: 789-793
        • Becciani R.
        • Faganello D.
        • Fradeani M.
        Surgical extrusion: a simplified esthetic method of treating non-restorable teeth. Rationale and case report.
        Int J Esthet Dent. 2018; 13: 240-273
        • Castelo-Baz P.
        • Quijada-Lopez S.
        • Barbieri Petrelli G.
        • Vila R.M.
        • Perez-Heredia M.
        • Martin-Biedma B.
        Surgical extrusion with biologically oriented preparation: an alternative to extraction.
        J Prosthet Dent. 2019; 121: 553-556
        • Karring T.
        • Nyman S.
        • Lindhe J.
        Healing following implantation or periodontitis affected roots into bone tissue.
        J Clin Periodontol. 1980; 7: 96-105
        • Karring T.
        • Isidor F.
        • Nyman S.
        • Lindhe J.
        New attachment formation on teeth with a reduced but healthy periodontal ligament.
        J Clin Periodontol. 1985; 12: 51-60
        • Lindhe J.
        • Nyman S.
        • Karring T.
        Connective tissue attachment as related to presence or absence of alveolar bone.
        J Clin Periodontol. 1984; 11: 33-40
        • Lee J.H.
        • Yoon S.M.
        Surgical extrusion of multiple teeth with crown-root fractures: a case report with 18-months follow up.
        Dent Traumatol. 2015; 31: 150-155
        • Shefter G.J.
        • McFall W.T.
        Occlusal relations and periodontal status in human adults.
        J Periodontal. 1984; 55: 368-374
        • Kelly R.
        • Addison O.
        • Tomson P.
        • Krastl G.
        • Dietrich T.
        Atraumatic extrusion to improve tooth restorability: a clinical report.
        J Prosthet Dent. 2016; 115: 649-653
        • Kahnberg K.E.
        Surgical extrusion of root-fractured teeth: a follow-up study of two surgical methods.
        Endod Dent Traumatol. 1988; 4: 85-89
        • Pham H.T.
        • Nguyen P.A.
        • Pham T.A.V.
        Periodontal status of anterior teeth following clinical crown lengthening by minimally traumatic controlled surgical extrusion.
        Dent Traumatol. 2018; 34: 455-463
        • Mohan K.
        • Ravindra R.
        • Roopa D.
        • Kishore K.
        Atraumatic surgical extrusion using periotome in esthetic zone: a case series.
        J Conserv Dent. 2013; 16: 175-179
        • Adreadsen J.O.
        A time-related study on periodontal healing and root resorption activity after replantation of mature permanent incisors in monkeys.
        Swed Dent J. 1980; 4: 101-110
        • Kim C.S.
        • Kim C.S.
        • Choi S.H.
        • Chai J.K.
        • Kim C.K.
        • Cho K.S.
        Surgical extrusion technique for clinical crown lengthening: report of three cases.
        J Periodontics Restorative Dent. 2004; 24: 412-421
        • Poggio C.
        • Dosoli R.
        • Ercoli C.
        A retrospective analysis of 102 zirconia single crowns with knife-edge margins.
        J Prosthet Dent. 2012; 107: 316-321
        • Maroulakos G.
        • Thompson G.
        • Kontogiorgos E.
        Effect of cement type on the clinical performance and complications of zirconia and lithium disilicate tooth-supported crowns: a systematic review. Report of the Committee on Research in Fixed Prosthodontics of the American Academy of Fixed Prosthodontics.
        J Prosthet Dent. 2019; 121: 754-765