Multidisciplinary Management of Anterior Traumatized Tooth: A Case Report

Abstract

Ab s t r Ac t Background: Traumatized anterior teeth with subgingival crown-root fractures are a challenge to treat. Treatment of crown-root fractures often requires a multidisciplinary approach. Gingivectomy of the affected tooth can violate gingival contour of the tooth so orthodontic extrusion is a conservative procedure that allows extrusion of a tooth without any bone loss. Case description: This case report details the multidisciplinary management of the traumatized anterior tooth including endodontic treatment, orthodontic extrusion, and post-core-crown procedure to restore a right maxillary central incisor to achieve a satisfactory cosmetic result. The fractured fragment was removed and pulp tissue extirpation was done in 11. Obturation was completed at next appointment. The fracture line was extended subgingivally, so orthodontic extrusion was planned. After 8 weeks, the tooth had extruded around 2 mm of palatal tooth structure sufficient to provide a ferrule of 1 mm. A cast post and core was prepared, and a definitive metal-ceramic crown was placed over 11. The patient was reviewed for 6 months and 1 year. Conclusion: Management of cervical third fracture has various treatment options. Orthodontic extrusion is a conservative procedure that allows retention of a tooth without any bone loss. Cast post and core can adapt to the canal and strengthen the tooth. It can be considered as a conservative treatment option.