Clinical Evaluation And Short Term Follow-up Of Tooth Extrusion In Retain Anterior Residual Root

The anterior teeth are exposed when speaking and smiling. The absence, defect or dysplasia of teeth, and alignment abnormity in anterior teeth can greatly influence the appearance, even affect the social intercourse, learning and occupation. So, dentists must improve the appreciation of the esthetics themselves. In clinical, the artificial teeth not only content exquisite, but also maintain the health of periodontal tissue and stability of restoration by multidisciplinary therapy. In this essay, maintaining the subgingival root and restoring by crown, space redistribution and restoring by cantilever bridge in anterior teeth were studied.Part I : Clinical Evaluation and Short Term Follow-up of Tooth Extrusion in Retain Anterior Residual RootThe literature documents the benefits of the multidisciplinary procedures in maintaining the subgingival root in anterior teeth. If the damage is near to the cemento-enamel junction, but below the gingival margin, a serial of procedures must be done if good prognosis are to be attained. At first, eliminate the infection by endodontic therapy; expose the defect secondly by orthodontic treatment, then trim the contour of gingival by surgical procedure, finally manufacture a restoration.8 cases were included in the essay, totally 10 anterior roots, 8 roots for the injuries and 3 roots for root caries. The defects were below the gingival margin 1.5~3.5mm. All cases are the outpatients who attended the prosthodontal department of Stomatoligical Hospital of Wuhan University. All cases were divided into 2 groups at random: the permanent post and core group by Ni-Cr alloy and the temporary post group by stainless steel. First, all cases were treated by endodontical therapy, recording the length of root. Then a forced eruption method was used to expose the defects in 4-8 weeks. The gingival reshaped and the circumferential supracrestalfiberotomy were executed after 3-4 weeks if the orthodontic procedure were completed. A temporary acrylic acid resin crown was used to maintain the position of the root and the contour of the gingival. Finally, a permanent crown was manufactured. The results were showed that:1. The suitable crown root ratio can be achieved by the forced eruption. The margins of the restoration can place the sound tooth structure. The health of periodontal tissue can be maintained. The gingivitis and second caries can be reduced.2. Compared with permanent post and core groups by Ni-Cr alloy , the seal of core and root is better in the temporary post groups by stainless steel group.3. No relapse was observed in short term follow-up.4. Compared with root extraction, the direct restoration, and the crown lengthening by surgical procedure, the forced eruption is a simple, economical and practical method in clinical.Part II: The Space Redistribution in Anterior Teeth and the Cantilever Bridge2 cases with smaller space in central incisors lost were collected. The space was enlarged by minor teeth movement first, then a cantilever bridge was made. The space redistribution with minor teeth movement before cantilever bridge restoration in a case is also discussed, whose canine was lost and space is too small.The results were showed that:1. 3 cases were satisfied after restoration.2. The more esthetic effect and the utmost protection of abutment can be acquired in cases which edentia space is smaller if the space was redistributed by minor teeth movement.