Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
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A multidisciplinary approach to restore crown-root fractured maxillary central incisors: orthodontic extrusion and surgical extrusion

치관-치근 파절이 발생한 상악 중절치를 수복하기 위한 다각적 접근법: 교정적 정출술과 외과적 정출술

  • Kwon, Eun-Young (Dental Clinic Center, Pusan National University Hospital) ;
  • Kim, So-Yeun (Dental Clinic Center, Pusan National University Hospital) ;
  • Jung, Kyoung-Hwa (Dental Clinic Center, Pusan National University Hospital) ;
  • Choi, Youn-Kyung (Dental Clinic Center, Pusan National University Hospital) ;
  • Kim, Hyun-Joo (Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University) ;
  • Joo, Ji-Young (Department of Periodontology, Dental and Life Science Institute, School of Dentistry, Pusan National University)
  • 권은영 (부산대학교병원 치과진료센터) ;
  • 김소연 (부산대학교병원 치과진료센터) ;
  • 정경화 (부산대학교병원 치과진료센터) ;
  • 최윤경 (부산대학교병원 치과진료센터) ;
  • 김현주 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 주지영 (부산대학교 치의학전문대학원 치주과학교실)
  • Received : 2020.08.14
  • Accepted : 2020.09.09
  • Published : 2020.12.31
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Abstract

To restore a tooth with a fracture line extending below the marginal bone level, a surgical crown lengthening procedure accompanied by ostectomy could be considered to expose the fracture line and reestablish the biologic width. However, this procedure could lead to esthetic failure, especially in the anterior teeth. Therefore, orthodontic extrusion, which elevates the fracture line from within the alveolar socket without sacrificing the supporting bone and gingiva, is recommended. This technique allows for the proper placement of the crown on a sound tooth structure, with the reestablishment of the biologic width. Alternatively, surgical extrusion is an one-step procedure that is simpler and less time-consuming than orthodontic extrusion; placing and adjusting the orthodontic appliance does not require multiple visits. This study presents successful restoration in 2 cases with a crown-tooth root fracture of the maxillary central incisor treated using a multidisciplinary approach through orthodontic extrusion or surgical extrusion followed by successful restoration.

변연골 하방으로까지 파절선이 연장된 치아를 수복하기 위해 파절선의 노출 및 생물학적 폭경의 재확립을 위한 삭제형 골수술을 동반한 외과적 치관 연장술을 고려해 볼 수 있다. 그러나 이 술식은 특히 전치부에서 심미성을 훼손시킬 수 있다. 따라서 지지골과 치은을 희생시키지 않으면서 파절선을 치조와 하방에서 상방으로 위치 시킬 수 있는 교정적 정출술이 권장된다. 이 술식은 생물학적 폭경의 재확립과 더불어 수복물을 건전한 치아 구조에 위치할 수 있도록 해 준다. 또 다른 대안으로, 교정적 정출술 보다 방법이 간단하며 시간이 적게 소요되고 한번의 술식만으로 정출이 완료되는 외과적 정출술도 고려해 볼 수 있다. 외과적 정출술을 이용할 경우 구강내 교정 장치를 위치시키고 조정하기 위해 환자가 치과에 여러번 방문할 필요가 없다. 본 연구에서는 상악 중절치에서 치관-치근 파절이 발생한 경우 교정적 정출술 또는 외과적 정출술을 통한 다각적 방법을 병용함으로써 성공적으로 수복한 증례를 보고하고자 한다.

Keywords

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