J Korean Acad Conserv Dent JKACD Journal of Korean Academy of Conservative Dentistry 1225-0864 2093-8179 The Korean Academy of Conservative Dentistry 10.5395/JKACD.2008.33.1.039 Case Report Anterior esthetic improvement through orthodontic extrusive remodeling and single-unit implantation in a fractured upper lateral incisor with alveolar bone loss: A case report Hwang Soo-Youn Shon Won-Jun Han Young-Chul Bae Kwang-Shik Back Seung-Ho Lee WooCheol Kum Kee-Yeon Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea. Corresponding Author: Kee-Yeon Kum. Department of Conservative Dentistry, School of Dentistry, Seoul National Dentistry, 92 Yunkun-Dong, Jongro-Gu, Seoul, 110-749, Korea. Tel: 82-2-2072-2651, Fax: 82-2-2072-2651, kum6139@snu.ac.kr 01 2008 31 01 2008 33 1 39 44 18 12 2007 06 01 2008 07 01 2008 Copyright © 2008 The Korean Academy of Conservative Dentistry 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured maxillary lateral incisor associated with alveolar bone loss, which was achieved by forced orthodontic extrusion before implant placement. Through these procedures we could reconstruct esthetics and function in a hopeless tooth diagnosed with subgingival root fracture by trauma.

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Clinical photo (Left) and the radiographic view of oblique crown-root fracture with alveolar bone loss in maxillary right lateral incisor (Right).

Clinical photo after connecting with brakets and 0.19 * 0.25 stainless steel orthodontic wire (left) and radiographic view (right).

Removal of upper fractured segment of crown (a), construction of post and resin core (b), stage of orthodontic eruptive force for 3 months (b, c), and retention wire for stabilization (d).

Single-unit implantation was inserted into the augmented bony site (a) and primary closure (b) was done using connective tissue (C) obtained from palatal mucosa.

Radiographic view (a) and final photo (b) after ceramic restoration.