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Dent Traumatol. 2014 Feb;30(1):1-14. doi: 10.1111/edt.12051. Epub 2013 Jun 25.

Adverse events of surgical extrusion in treatment for crown-root and cervical root fractures: a systematic review of case series/reports.

Author information

1
Pediatric Dentistry Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.

Abstract

BACKGROUND:

Crown-root and cervical root fractures constitute a restorative challenge due to sub-gingival position of the fracture margin. Surgical tooth extrusion is one of the treatment options. There is uncertainty regarding the prognosis of such treatment modality.

OBJECTIVE:

To assess adverse events of surgical tooth extrusion in the treatment for crown-root and cervical root fractures in permanent teeth.

METHODS:

PubMed, Embase, and Google Scholar were searched through 15th of June 2012. Search was limited to English and Arabic languages. Reference list of relevant studies were hand-searched. Grey literature was searched using Open Grey. Two review authors independently extracted data, while only one assessed trial quality using 8-point methodological index for non-randomized studies (MINORS) scale. A sensitivity analysis was performed to exclude studies with suspected patients' duplicates.

RESULTS:

Eleven case reports and eight case series involving 226 patients with 243 teeth were identified. No randomized controlled trials were found. The mean quality score for all case series was 9 suggesting a fair quality, while that of all case reports was 5 suggesting poor quality. Non-progressive root resorption is the most common finding following surgical extrusion with an event rate of 30% (95% CI 24.6-36.7%). This is followed by low event rates of tooth loss (5%), slight mobility (4.6%), marginal bone loss (3.7%), and progressive root resorption (3.3%). No ankylosis occurred to any extruded tooth, while severe tooth mobility showed negligible overall event rate of 0.4%.

CONCLUSION:

The available evidence suggests that surgical tooth extrusion is a valid technique in management of crown-root and cervical root fracture of permanent teeth. Minimal adverse events and good prognosis are expected. Further, surgical extrusion can be considered as a treatment option in teeth suffering sub-gingival decay.

KEYWORDS:

ankylosis; crown-root fracture; prognosis; root resorption

PMID:
23796195
DOI:
10.1111/edt.12051
[Indexed for MEDLINE]

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