Dental fracture with invasion of biological space: Multidisciplinary treatment
DOI:
https://doi.org/10.33448/rsd-v10i5.15003Keywords:
Orthodontic extrusion; Biological space; Rehabilitation.Abstract
Periodontal health and restorative procedures are closely related and need to be in harmony. The treatment only presents a good prognosis when mechanical, biological and esthetic aspects are respected. The biological space has the function of protecting the dental element support tissues against bacterial aggression and its toxins, and its preservation is essential for proper rehabilitation. Periodontal surgery involving detachment of a full flap, osteotomy and osteoplastic are contraindicated in some cases due to compromised esthetics. Thus, orthodontic extrusion combined with fibrotomy is a treatment possibility, especially when it involves the anterior region of the maxilla. The purpose of this article is to report and discuss a clinical case of an upper incisors coronoradicular fracture with invasion of the biological space. The case had a multidisciplinary approach and planning according to the patient's socioeconomic status, with a view to subsequent prosthetic rehabilitation. First, endodontic treatment was performed, intraradicular retention with fiberglass pins and temporary crowns. Subsequently, orthodontic root extrusion was performed using acetate plates and orthodontic elastics to re-establish the biological space. With adequate planning and performance of the correct technique it was possible to provide a subsequent favorable prosthetic rehabilitation with good prognosis.
References
Cabral, F., Serra, M., Santos, F.M.L., Luis, C., Kyrillos, M., Moreira, M., et al. (2017) Como alcançar resultados satisfatórios frente a uma limitação biológica? A interface entre as especialidades para a melhor solução clínica. J Clin Dent Res, 14(3), 42-58.
Calicchio, L., Kyrillos, M., Moreira, M., Giordani, G., Cabral, F., Nhoncance, W., et al. (2016) Odontologia minimamente invasiva aplicada na transformação estética do sorriso. J Clin Den Res, 13(4), 53-64.
Clark, D., & Levin, L. (2019). In the dental implant era, why do we still bother saving teeth? Dental traumatology: official publication of International Association for Dental Traumatology, 35(6), 368–375.
Cloet, E., Debels, E., & Naert, I. (2017) Controlled Clinical Trial on the Outcome of Glass Fiber Composite Cores Versus Wrought Posts and Cast Cores for the Restoration of Endodontically Treated Teeth: A 5-Year Follow-up Study. Int J Prosthodont, 30(1), 71-79.
Farias, F. A. R., Feltrin, P. P., Zanetti, A. L. E., & Inoue, R. T. (2011) Preparo dentário para coroa metalocerâmica em dentes anteriores, por meio da técnica de referência Inoue & Zanetti. RGO, 59(1) 81-88.
Figueiredo, F. E. D., Martins F. P. R. S., & Faria S. A. L. (2015) Do Metal Post–retained Restorations Result in More Root Fractures than Fiber Post–retained Restorations? A Systematic Review and Meta-analysis. Journal of Endodontics, 41(3), 309–316.
Gargiulo, A.W., Wentz, F.M., & Orban, B. (1961) Dimensions and relations of the dentogingival junctions in humans. J Periodontol ,32, 261-97.
Goenka, P., Marwah, N., & Dutta, S. (2011) A multidisciplinary approach to the management of a subgingivally fractured tooth: a clinical report. J Prosthodont, 20(3):218-223.
Goyatá, F.R., Thomé, E.M.O.S., Brum, S.C., Oliveira, R.S., & Ferreira, T.F.R.Z. (2008) Multidisciplinary restoration treatment – a clinical report. Int J Dent, Recife, 7 (2),142-146.
Gunay, H., Seeger, A., Tschernitschek, H., & Geurtsen W. (2000) Placement of the preparation line and periodontal health--a prospective 2-year clinical study. Int J Periodontics Restorative Dent, 20 (2),171-81.
Janson, M.R.P., Passanezi E., Jason, R.R.P., & Pinzan, A. (2002) Tratamento Interdisciplinar II - Estética e distância biológica: Alternativas ortodônticas para remodelamento vertical do periodonto. R Dental Press Ortodon Ortop Facial, 7(4), 85-105.
Kozlovsky, A., Tal, H., & Lieberman, M. (1988) Forced Eruption Combined with gingival fiberotomy: A technique for clinial crown lengthening. J Clin Periodontol, l5, 534-538.
Martos, J., Silveira, L. F. M., Baldisserra, R.A., & Cruz, L. E. R. N. (2014) Extrusão ortodôntica e realinhamento do espaço biológico em pré-molar com fratura subgengival. Revista Odontológica do Brasil Central,23(67),212-216.
Mendoza R.S., Szalay, E. R., Treviño, A.S., & Olivares, S. T. (2012). Multi-disciplinary prosthetic rehabilitation: Clinical case report. Revista odontológica mexicana, 16(2), 112-122.
Munõz-Chaves, O. F., Lombardo, G. H. L., Terence, R. L., & Araújo, P. C. A. (2002) Prótese fixa metalocerâmica com liga de titânio comercialmente pura. Revista Brasileira de Prótese Clínica e Laboratorial, 4(19), 196-201.
Normando, A.D.C., Simone, J.L., Soares, M.S., & Tortamano N. (2004) A extrusão ortodôntica como recurso no tratamento das invasões dos espaços biológicos periodontais – indicação clínica e divulgação de um método simplificado de tratamento. J Bras Ortodon Ortop Facial, 9(53), 502-10.
Odeh, N. D., Babkair, H., Abu-Hammad, S., Borzangy, S., Abu-Hammad, A., & Abu-Hammad, O. (2020). COVID-19: Present and Future Challenges for Dental Practice. International journal of environmental research and public health, 17(9), 3151.
Pegoraro, L. F., Araújo, C. dos R. P., Bonfante, G., & Conti, P. C. R. (2013). Prótese fixa: bases para o planejamento em reabilitação oral. São Paulo: Artes Médicas.
Pontoriero, R., Celenza F, Jr., Ricci, G., & Carnevale, G. (1987) Rapid extrusion with fiber resection: a combined orthodontic-periodontic treatment modality. Int J Periodontics Restorative Dent, 7(5):30-43.
Ramalho, A. C.D., Mariz, A. L., Beatrice, L.C.S., Silva, C. H.V., & Filho, P.V.M. (2008) Estudo comparativo da resistência radicular à fratura em função do comprimento e da composição do pino. RFO,13(3), 42-46.
Reis, B. R., Soares, P. B. F., Castro, C.G,. Santos Filho P.C. F., Soares, P. V., & Soares, C.J.(2010) All ceramic crown associated to fiberglass post: a clinical case report. Robrac, 19(50).
Romanelli J. (2014) Reabilitações estéticas gengivais compostas pela extrusão ortodôntica. Rev Dental Press Estét, 11(1):46-59.
Santos Silva, M. D., Vitório de Farias Sá, A. K., Mello Figueiredo, L., & D’Almeida Borges, C. (2020). Extrusão ortodôntica de dentes traumatizados: revisão integrativa da literatura. Caderno De Graduação - Ciências Biológicas E Da Saúde - UNIT, 6(2), 50.
Silva, A. B. R., Alves, H., Lazarino, V. L., Nascimento, Y. M. L. do., Castello, L. F. M., Costa, A. M. C., Oliveira, T. T. C. de., Pingarilho, L., Santos, T. de S., & Macedo, I. de A. B. (2020). Minimally invasive surgical techniques in clinical crown lengthening: A systematic review. Research, Society and Development, 9(10), e579108256.
Teixeira, R. O., Falabella, M. E.V., Falabella, J.M., Teixeira, H.G.C., & Calvário, M. A.F. (2007) Tracionamento dentário com finalidade periodontal: relato de caso. RGO, 55(4),404-411.
Tomar, N., Bansal,T., Bhandari, M., & Sharma, A. (2013) The perio-esthetic-restorative approach for anterior rehabilitation. J Indian Soc Periodontol, 17(4), 535-538.
Wang, X., Shu, X., Zhang, Y., Yang, B., Jian, Y., & Zhao, K. (2019) Evaluation of fiber posts vs metal posts for restoring severely damaged endodontically treated teeth: a systematic review and meta-analysis. Quintessence Int, 50(1):8-20.
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Copyright (c) 2021 Bianca Joaquim do Nascimento; Ana Julia Furlan da Silva ; Roberto Prescinotti; Maria Beatriz Bergonse Pereira Pedriali ; Amanda Vessoni Barbosa Kasuya
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