Alternative Approach for the Management of Complete Crown Fracture with Periapical Lesion by Apicoectomy and Orthodontic Extrusion Using Removable Appliance

Abstract

Trauma induced periapical lesions often require complex treatment, as conventional root canal therapy poses a high risk of failure due to apical transportation of infection. However, complete crown fractures with a fracture line close to the gingiva or extending subgingivally may require orthodontic extrusion to re-establish the biologic width thereby achieving aesthetic and functional restoration of the tooth. The purpose of this case report is to suggest an alternative treatment approach to achieve healing of periapical lesions and causing extrusion of the teeth by moving the fracture line above the supragingival level for final aesthetic and functional restoration. This case report discusses the management of an anterior tooth with long-standing subgingival fracture and large cyst-like periapical lesion using apicoectomy and orthodontic extrusion with a removable appliance.