Keinan David, Szwec Jerard, Matas Avital, Moshonov Joshua, Yitschaky Oded
When this article was written, Dr. Keinan was the head, Department of Endodontics, Medical Corps, Dental Center, Sheba Medical Center, Tel-Hashomer, Israel.
J Am Dent Assoc. 2013 Aug;144(8):910-3. doi: 10.14219/jada.archive.2013.0208.
Complicated tooth fractures can be the unfortunate result of orofacial trauma and can offer a therapeutic challenge for the dentist. A conservative solution for gaining supragingival sound tooth structure often includes orthodontic forced eruption. Usually, this procedure is carried out by applying extrusive force after placing a provisional acrylic Richmond crown on the tooth. However, this long-lasting dental treatment may jeopardize the coronal seal of the root canal space, leading to microleakage and endodontic failure.
Orthodontic forced eruption demands application of force to an attachment connected to the remaining short clinical crown. In this article, the authors describe a case in which they used a new technique for orthodontic forced eruption of a traumatized tooth, using an extracanal attachment to apply extrusion force, and discuss its possible advantages and limitations.
An extracanal attachment approach for orthodontic forced eruption without compromising the obturated canal space can be a solution for posttraumatic crown fracture. Practical Implications. The described procedure for forced eruption by using an extracanal pin attachment is efficient and convenient and does not require the clinician to apply force directly to the provisional crown. Therefore, during the application of force, there is less risk of loosening the provisional crown, and the canal space is kept intact with either the final restoration or dressing material.
复杂的牙齿骨折可能是口腔颌面部创伤的不幸后果，对牙医来说是一个治疗挑战。获得龈上健康牙体结构的保守解决方案通常包括正畸强制萌出。通常，此程序是在牙齿上放置临时丙烯酸类里士满冠后施加挤出力来进行的。然而，这种长期的牙科治疗可能会危及根管空间的冠部封闭，导致微渗漏和牙髓治疗失败。
正畸强制萌出需要对连接到剩余短临床冠的附件施加力。在本文中，作者描述了一个病例，他们使用一种新技术对一颗受创伤的牙齿进行正畸强制萌出，使用根管外附件施加挤出力，并讨论了其可能的优点和局限性。
一种不影响封闭根管空间的正畸强制萌出的根管外附件方法可以作为创伤后冠折的一种解决方案。实际意义。所描述的使用根管外针附件进行强制萌出的程序高效且方便，不需要临床医生直接对临时冠施加力。因此，在施加力的过程中，临时冠松动的风险较小，并且根管空间通过最终修复体或敷料材料保持完整。
