J Korean Assoc Oral Maxillofac Surg.  2019 Oct;45(5):254-259. 10.5125/jkaoms.2019.45.5.254.

Surgical extrusion of a maxillary premolar after orthodontic extrusion: a retrospective study

Affiliations
  • 1Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 2Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea. 65592@snubh.org

Abstract


OBJECTIVES
Crown-root fracture and cervical caries in maxillary premolars constitute a challenge in cases of subgingival placement of restoration margins. Surgical extrusion has been practiced successfully in permanent anterior teeth. The aim of the present retrospective study was to assess the clinical outcome of surgical extrusion after orthodontic extrusion in maxillary premolars.
MATERIALS AND METHODS
Twenty-one single, tapered root maxillary premolars with subgingival crown-root fracture or caries were included. Presurgical orthodontic extrusion was performed on all teeth to prevent root resorption. Extent of extrusion and rotation was determined based on crown/root ratio. The postoperative splinting period was 7 to 14 days. Clinical and radiographic examination was performed at an interval of 1, 2, and 3 months.
RESULTS
After the mean follow-up of 41.9±15.2 months, failure was observed as increased mobility in 3 of 21 cases. No significant difference was observed in the outcome of surgical extrusion based on tooth type, age, sex, 180° rotation, or time for extraction. Furthermore, marginal bone loss was not observed.
CONCLUSION
Surgical extrusion of maxillary premolars can be a possible therapeutic option in cases of subgingival crown-root fracture.

Keyword

Surgical extrusion; Maxillary premolar; Surgical crown lengthening

MeSH Terms

Bicuspid*
Follow-Up Studies
Orthodontic Extrusion*
Retrospective Studies*
Root Caries
Root Resorption
Splints
Tooth

Figure

  • Fig. 1 A. Clinical photograph of maxillary second premolar showing subgingival crown-root fracture resulting in pulp exposure. B. Prominent periodontal ligament space is observed in the 5-year follow-up radiograph. Note the elevated marginal bone level along with root surface, which might be the bone induction capability of periodontal ligament cells attached on to the extruded root surface.


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