Lee Bumjoon, Shin Jonghyun, Jeong Taesung, Park Soyoung, Lee Eungyung
Department of Pediatric Dentistry, Dental Research Institute, Pusan National University Dental Hospital, 20 Geumo-Ro, Mulgeum-Eup, Yangsan-Si, Gyeongsangnam-Do, 50612, Republic of Korea.
Department of Pediatric Dentistry, School of Dentistry, Dental and Life Science Institute, Pusan National University, 49, Busandaehak-ro, Mulgeum-Eup, Yangsan-Si, Gyeongsangnam-Do, 50612, Republic of Korea.
BMC Oral Health. 2024 Dec 18;24(1):1498. doi: 10.1186/s12903-024-05277-4.
Preservation of a healthy periodontium is critical for the long-term success of restored teeth. In cases of extensive caries, tooth fracture, inadequate crown length, and increased esthetic demands, the restorative margins need to be placed apical to the gingival margin. Violation of the biological width due to dental trauma frequently appears in clinical practice. There are three treatment options for preserving biological width and the ferrule effect: crown lengthening, orthodontic extrusion, and surgical extrusion. This case report describes the surgical intervention and fixed prostheses for crown-root fractured maxillary incisors in a growing patient.
A fourteen-year-old boy was referred from Department of Oral and Maxillofacial Surgery and visited the Department of Pediatric Dentistry after emergency dental treatment. He got hit with a baseball bat and his upper right central and lateral incisors were fractured with pulp exposure. A vertical fracture line extended 2 mm below gingival margin was observed. Surgical extrusion and conventional root canal treatments were performed on both fractured teeth. Surgical crown lengthening was additionally done to preserve the biological width and to make sure of the ferrule effect. Then, these teeth were finally restored with porcelain fused metal crowns.
Surgical extrusion and crown lengthening may be considered the most effective treatments to save the teeth instead of coronectomy or extraction for severely fractured teeth. The case described here showed satisfactory esthetic and periodontal outcomes during two years of follow-up, and the patient was satisfied that he could retain his natural teeth.
保持健康的牙周组织对于修复牙齿的长期成功至关重要。在广泛龋坏、牙齿折断、冠部长度不足以及美观需求增加的情况下，修复边缘需要置于龈缘下方。临床上因牙外伤导致生物学宽度破坏的情况屡见不鲜。保留生物学宽度和箍效应有三种治疗选择：冠延长术、正畸牵引和手术牵引。本病例报告描述了一名生长发育期患者上颌冠根折裂切牙的手术干预及固定修复。
一名14岁男孩从口腔颌面外科转诊而来，在接受急诊牙科治疗后就诊于儿童牙科。他被棒球棒击中，右上中切牙和侧切牙折断并露髓。观察到一条垂直骨折线延伸至龈缘下方2毫米处。对两颗折断牙进行了手术牵引和常规根管治疗。此外，还进行了手术冠延长术以保留生物学宽度并确保箍效应。然后，最终用烤瓷熔附金属冠修复这些牙齿。
对于严重折裂的牙齿，手术牵引和冠延长术可能被认为是保存牙齿最有效的治疗方法，而不是截冠术或拔牙。此处描述的病例在两年的随访期间显示出令人满意的美学和牙周效果，患者对能够保留自己的天然牙感到满意。
