Journal of Prosthetic Dentistry

Forced orthodontic extrusion for an apparently hopeless anterior tooth by using a simplified approach

Published:September 20, 2022DOI:


      When restoring severely compromised teeth, respecting the supracrestal tissue attachment and retaining the most coronal and radicular tooth structure is essential to achieving a sufficient ferrule. Forced orthodontic extrusion is a minimally invasive method that allows hard- and soft-tissue conservation. This article describes the treatment of a severely damaged maxillary central incisor that was managed by using a simplified orthodontic extrusion method with intracoronal elastic and metal ligatures applied through a palatal bar and followed by the biologically oriented preparation technique (BOPT). This orthodontic procedure reduces a forward clockwise advance during vertical extrusion, thus maintaining the buccal bone plate.
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        • Bruhnke M.
        • Spies B.
        • Beuer F.
        • Neumeyer S.
        Forced orthodontic extrusion: a practical therapy method for apparently hopeless teeth? A case report.
        Int J Prosthodont. 2020; 33: 684-688
        • Gargiulo A.
        • Wentz F.
        • Orban B.
        Dimensions and relation of the dentogingival junction in humans.
        J Periodontol. 1961; 32: 261-267
        • Stankiewicz N.R.
        • Wilson P.R.
        The ferrule effect: a literature effect.
        Int Endod J. 2002; 35: 575-581
        • Ghezzi C.
        • Brambilla G.
        • Conti A.
        • Dosoli R.
        • Ceroni F.
        • Ferrantino L.
        Cervical margin relocation: case series and new classification system.
        Int J Esthet Dent. 2019; 14: 272-284
        • Sarfati A.
        • Tirlet G.
        Deep margin elevation versus crown lengthening: biologic width revisited.
        Int J Esthet Dent. 2018; 13: 334-356
        • Padbury Jr., A.
        • Eber R.
        • Wang H.L.
        Interactions between the gingiva and the margin of restorations.
        J Clin Periodontol. 2003; 30: 379-385
        • Jepsen S.
        • Caton J.G.
        • Albandar J.M.
        • et al.
        Periodontal manifestations of systemic diseases and developmental and acquired conditions: consensus report of Workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.
        J Periodontol. 2018; 89: S237-S248
        • Dietschi D.
        • Spreafico R.
        Current clinical concepts for adhesive cementation of tooth-colored posterior restorations.
        Pract Periodontics Aesthet Dent. 1998; 10: 47-54
        • Ingber J.S.
        • Rose L.F.
        • Coslet J.G.
        The “biologic width”--a concept in periodontics and restorative dentistry.
        Alpha Omegan. 1977; 70: 62-65
        • Nevins M.
        • Skurow H.M.
        The intracrevicular restorative margin, the biologic width, and the maintenance of the gingival margin.
        Int J Periodontics Restorative Dent. 1984; 4: 30-49
        • Wagenberg B.D.
        • Eskow R.N.
        • Langer B.
        Exposing adequate tooth structure for restorative dentistry.
        Int J Periodontics Restorative Dent. 1989; 9: 322-331
        • Ross S.E.
        • Garguilo A.
        The surgical management of the restorative alveolar interface.
        Int J Periodontics Restorative Dent. 1982; 2: 8-31
        • Deas D.E.
        • Moritz A.J.
        • McDonnell H.T.
        • Powell C.A.
        • Mealey B.L.
        Osseous surgery for crown lengthening: a 6-month clinical study.
        J Periodontol. 2004; 75: 1288-1294
        • Gegauff A.G.
        Effect of crown lengthening and ferrule placement on static load failure of cemented cast post-cores and crowns.
        J Prosthet Dent. 2000; 84: 169-179
        • Dietschi D.
        • Duc O.
        • Krejci I.
        • Sadan A.
        Biomechanical considerations for the restoration of endodontically treated teeth: a systematic review of the literature - part 1. Composition and micro- and macrostructure alterations.
        Quintessence Int. 2007; 38: 733-743
        • Kim S.H.
        • Tramontina V.
        • Passanezi E.
        A new approach using the surgical extrusion procedure as an alternative for the reestablishment of biologic width.
        Int J Periodontics Restorative Dent. 2004; 24: 39-45
        • Juloski J.
        • Radovic I.
        • Goracci C.
        • Vulicevic Z.R.
        • Ferrari M.
        Ferrule effect: a literature review.
        J Endod. 2012; 38: 11-19
        • González-Martín O.
        • Solano-Hernandez B.
        • González-Martín A.
        • Avila-Ortiz G.
        Orthodontic extrusion: guidelines for contemporary clinical practice.
        Int J Periodontics Restorative Dent. 2020; 40: 667-676
        • Fakhry A.
        Enhancing restorative, periodontal, and esthetic outcomes through orthodontic extrusion.
        Eur J Esthet Dent. 2007; 2: 312-320
        • Heithersay G.S.
        Combined endodontic-orthodontic treatment of transverse root fractures in the region of the alveolar crest.
        Oral Surg Oral Med Oral Pathol. 1973; 36: 404-415
        • Ingber J.S.
        Forced eruption. I. A method of treating isolated one and two wall infrabony osseous defects-rationale and case report.
        J Periodontol. 1974; 45: 199-206
        • Ingber J.S.
        Forced eruption: part II. A method of treating nonrestorable teeth--periodontal and restorative considerations.
        J Periodontol. 1976; 47: 203-216
        • Pontoriero R.
        • Celenza Jr., F.
        • Ricci G.
        • Carnevale G.
        Rapid extrusion with fiber resection: a combined orthodontic-periodontic treatment modality.
        Int J Periodontics Restorative Dent. 1987; 7: 30-43
        • Hochman M.N.
        • Chu S.J.
        • Tarnow D.P.
        Orthodontic extrusion for implant site development revisited: a new classification determined by anatomy and clinical outcomes.
        Semin Orthod. 2014; 20: 208-227
        • Loi I.
        • Di Felice A.
        Biologically oriented preparation technique (BOPT): a new approach for prosthetic restoration of periodontically healthy teeth.
        Eur J Esthet Dent. 2013; 8: 10-23
        • Naumann M.
        • Schmitter M.
        • Frankenberger R.
        • Krastl G.
        “Ferrule comes first. Post is second!” Fake news and alternative facts? A systematic review.
        J Endod. 2018; 44: 212-219
        • Zarow M.
        • Ramírez-Sebastià A.
        • Paolone G.
        • de Ribot Porta J.
        • Mora J.
        • Espona J.
        • et al.
        A new classification system for the restoration of root filled teeth.
        Int Endod J. 2018; 51: 318-334
        • 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
        • Plotino G.
        • Abella Sans F.
        • Duggal M.S.
        • et al.
        Clinical procedures and outcome of surgical extrusion, intentional replantation and tooth autotransplantation - a narrative review.
        Int Endod J. 2020; 53: 1636-1652
        • Salama H.
        • Salama M.
        • Garber D.
        Guidelines for aesthetic restorative options and implant site enhancement: the utilization of orthodontic extrusion.
        Pract Proced Aesthet Dent. 2002; 14: 125-130
        • Casaponsa J.
        • de Ribot D.
        • Roig M.
        • Abella F.
        Magnetic extrusion technique for restoring severely compromised teeth: a case report.
        J Prosthet Dent. 2022; 127: 542-549
        • Agustín-Panadero R.
        • Serra-Pastor B.
        • Loi I.
        • Suárez M.J.
        • Pelaez J.
        • Solá-Ruíz F.
        Clinical behavior of posterior fixed partial dentures with a biologically oriented preparation technique: a 5-year randomized controlled clinical trial.
        J Prosthet Dent. 2021; 125: 870-876