Forced Eruption for Restorative Purposes: A Literature Review



Grace Huang
Rekha Manoharan
SHERRY YANG
Mohammad Qali
Yu Cheng Chang

Huang, Grace1, Manoharan, Rekha1, Yang, Sherry1, Qali, Mohammad2
Faculty / Advisor: Chang, Yucheng
1University of Pennsylvania School of Dental Medicine, Department of Periodontics
2University of Pennsylvania School of Dental Medicine, Department of Orthodontics

Introduction

The objective of this paper is to investigate and concisely review the available literature discussing orthodontic extrusion for two purposes: crown lengthening and implant site development. For restorations on teeth with caries, horizontal fractures, internal and external resorptions, and perforations invading the biological width as well as for establishment of the ferrule effect in teeth requiring full-coverage restorations, crown lengthening is required for long-term tissue health. In the same fashion, site development is often necessary prior to implant placement in order to provide optimal peri-implant soft and hard tissue architecture conducive to future esthetics and function.

Methods

N/A

Results

Compared to traditional crown lengthening surgery, forced eruption is advantageous because it preserves supporting bone, provides improved esthetics, limits the involvement of adjacent teeth, and does not negatively impact crown to root ratio. As a noninvasive and natural technique capable of increasing the available volume of bone and soft tissue, orthodontic extrusion is also an attractive and promising option for implant site development. Both fixed and removable appliances can be used to achieve the desired extrusion, but patient compliance is a primary limiting factor for the utilization of removable appliances.

Conclusion

Orthodontic extrusion is a valuable treatment adjunct for patients requiring crown lengthening or implant restorations. Nonetheless, comprehensive evaluation and treatment planning is required for appropriate case selection based upon the known indications and contraindications for each purpose; major contraindications include inflammation, ankylosis, hypercementosis, vertical root fracture, and root proximity. Further studies are necessary to elucidate the long-term stability of orthodontically extruded teeth and the supporting bone and soft tissue that followed them.