Alessandri Bonetti Giulio, Incerti Parenti Serena, Ciocci Maurizio, Checchi Luigi
Unit of Orthodontics, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy.
Private Practice, Faenza (Ravenna), Italy.
Korean J Orthod. 2014 Jul;44(4):217-25. doi: 10.4041/kjod.2014.44.4.217. Epub 2014 Jul 24.
Single-tooth implantation has become a common treatment solution for replacement of a root-fractured maxillary incisor in adults, but the long-term esthetic results can be unfavorable due to progressive marginal bone loss, resulting in gingival recession. In this case report, a maxillary central incisor with a root fracture in its apical one-third was orthodontically extruded and extracted in a 21-year-old female. Implant surgery was performed after a 3-month healing period, and the final crown was placed about 12 months after extraction. After 12 years, favorable osseous and gingival architectures were visible with adequate bone height and thickness at the buccal cortical plate, and no gingival recession was seen around the implant-supported crown. Although modern dentistry has been shifting toward simplified, clinical procedures and shorter treatment times, both general dentists and orthodontists should be aware of the possible long-term esthetic advantages of orthodontic extrusion of hopelessly fractured teeth for highly esthetically demanding areas and should educate and motivate patients regarding the choice of this treatment solution, if necessary.
单颗牙种植已成为成人上颌中切牙根折后常见的治疗方案，但由于边缘骨逐渐吸收导致牙龈退缩，长期美学效果可能不佳。在本病例报告中，一名21岁女性的上颌中切牙牙根在根尖三分之一处发生骨折，先通过正畸方法将其牵引出后再拔除。拔牙后经过3个月的愈合期进行种植手术，拔牙后约12个月安装最终牙冠。12年后，骨组织和牙龈结构良好，颊侧骨皮质板处骨高度和厚度足够，种植体支持的牙冠周围未见牙龈退缩。尽管现代牙科一直在朝着简化临床操作和缩短治疗时间的方向发展，但普通牙医和正畸医生都应意识到，对于美学要求较高的区域，正畸牵引无望保留的骨折牙可能具有长期美学优势，如有必要，应就这种治疗方案的选择对患者进行教育并给予激励。
