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In case of esthetic zone it’s preferable to make orthodontic extrusion but its drawback that its take time , as for crown lengthening it’s not going to good esthetically if made in the fractured tooth only but we can made it for the entire esthetic area but that will be a destructive treatment
In non-esthetic zone we can make crown lengthening but without neglecting the 1:1 crown root ratio and the position of alveolar bone in molar area so doesn’t cause furcation involvement also orthodontic extrusion can be made
crown lenghtening ,with a core build up and management of root canal
Restor teeth with composite core
Crown lenghtening
Extrusion with Orthodontics
in such case my line of treatment would be advicing RCT to that tooth and post and core build up will be the best option.
In esthetic zone, forced orthodontic eruption of the tooth would be ideal than crown lengthening when the fracture is at the level of the alveolar crest.
In case of non-esthetic zone crown lengthening could be attempted with osseous recontouring in order to maintain the biologic width or extraction followed by implant crown replacement in case of poor prognosis.
Ferrule effect is presence of 360 degree of metal collor of crown surrounding the parallel walls of the tooth structure, which in this case is absent due to fracture at the level of alveolar crest, hence best way is to do a crown lengthening procedure before proceeding with the post and core, so as to have a sound tooth structure above the crest.
If it in the aesthetic zone you should to be more carefully to choice the treatment plane may be RCT then post and core build up and crown applying , otherwise in another area not zone of aesthetic you can extracted it and then Implant the tooth in missed area
crown lengthening is the optimum solution
orthodontic extrusion is the best way because the ferrule should always b on the natural teeth as far as possible
Forced eruption of the tooth so as to maintain a healthy root-crown ratio to prevent root fractures due to strees build up, followed by post and core.
HORIZONTAL ROOT FRACTURE AT THE LEVEL OF THE ALVEOLAR CREST
POST AND CORE BUILD UP. GINGIVAL RETRACTION TO ENABLE SUBGINGIVAL TOOTH MARGIN SO AS TO BRACE THE TOOTH. THE AMOUNT OF GINGIVA ABOVE THE BONE WILL ALSO MATTER; IF ITS EXCESS DOING A CORE BUILDUP WILL HAVE POOR PROGNOSIS.
AN IMPLANT/FPD PROSTHESIS WOULD THEREFORE BE A BETTER OPTION.
