Endodontic Referral Practice, Cuneo (CN), Italy.
Dent Traumatol. 2010 Feb;26(1):98-104. doi: 10.1111/j.1600-9657.2007.00519.x.
This case report describes the management of an oblique crown-root fracture of the buccal cusp of the upper right first premolar. After removal of the fractured cusp, a provisional restorative build-up in this area was carried out, in order to carry out an endodontic treatment in a sterile environment. A glass fibre post and core were then constructed and over a 90-day period the tooth was extruded orthodontically by 4 mm. The periodontal fibres associated with this tooth were cut with a tiny surgical blade to help to prevent reintrusion of the tooth and achieve fine contouring of the gingival margins. The new tooth position was maintained with a retainer for a further 60 days and after a period with a provisional acrylic crown, a porcelain bonded crown was fitted. This case report demonstrates that such a multidisciplinary treatment approach to an oblique subgingival fracture is a reliable and predictable manner in which to save a tooth that would have otherwise been difficult, if not impossible, to restore with a resultant good long-term prognosis.
本病例报告描述了一例上颌右第一前磨牙颊侧斜向冠根折的处理方法。在去除折断的牙尖后，在该区域进行了临时修复，以便在无菌环境下进行根管治疗。然后构建了玻璃纤维桩核，并通过正畸将牙齿向外挤压 4 毫米，历时 90 天。用微型手术刀片切断与该牙相关的牙周纤维，有助于防止牙齿重新内陷，并实现牙龈边缘的精细塑形。用保持器保持新的牙齿位置 60 天，然后用临时丙烯酸冠保持一段时间，再安装烤瓷熔附金属冠。本病例报告表明，对于这种龈下斜向折裂，采用多学科治疗方法是一种可靠且可预测的方法，可以保留牙齿，否则用其他方法修复则非常困难，如果不是不可能的话，也可以获得良好的长期预后。
