Use of orthodontic extrusion as aid for restoring extensively destroyed teeth: a case series

Forced orthodontic extrusion may represent a valid option for clinicians in different clinical situations. Extrusive movements lead to an improvement in the vertical amount of both hard and soft tissues. Major advantages of this procedure are related to the quality of the regenerated tissues, since they determine the vertical apposition of new endogenous bone. In this paper, we report a case series of in which forced orthodontic extrusion in combination with other, surgical- or nonsurgicaltechniques, led to recovery of "hopeless" teeth and avoided implant-supported restorations. In some cases a surgical fiberotomy was performed in order to improve the amount of healthy tissues available for the subsequent restoration. A long term follow up revealed that a multidisciplinary approach including: endodontic therapy, surgical crown lengthening or/and orthodontic extrusion followed by rehabilitation with fixed partial prosthesis (FPP) could lead to long survival rate even for "hopeless" teeth. These procedures have the aim to expose a sufficient amount of circumferential healthy tooth tissues that is fundamental to obtain a ferrule effect for the subsequent prosthetic restoration. Forced orthodontic extrusion represents an important technique in the hands of clinicians for the resolution of difficult situations. Although it is a safety and predictive technique, collaboration by the patient is necessary, in order to achieve desired results at the end of the extrusion period.