Enhancing restorative, periodontal, and esthetic outcomes through orthodontic extrusion

Traumatic tooth fractures, dental caries, and overzealous tooth preparations can lead to the loss of coronal tooth structure, thus complicating the definitive prosthetic plan. Although exposure of additional clinical tooth structure by surgical crown lengthening is often recommended, such an approach is usually discouraged because of the possible adverse periodontal changes to the adjacent teeth and compromised esthetics, especially in the presence of an otherwise intact arch. This article discusses the application of orthodontic extrusion to conservatively restore a single tooth with minimal coronal tooth structure in the esthetic zone. A detailed description of the prosthetic approach used before, during, and after orthodontic therapy is presented.