Alterações verticais no periodonto relacionadas com a extrusão ortodôntica: revisão de literatura e apresentação de caso clínico

Abstract

Fractures, wide cavities or external resorption on subgingival level, iatrogenic perforation and the presence of vertical bone defects are alterations related to periodontal impairment and consequently offer difficulties for that region reestablishment. The treatment of those teeth is a challenge to Dentistry, especially when located on the anterior upper arch region, by presenting a bigger esthetic demand and in large part depending on the surrounding periodontal tissue conditions, for the procedure success. The orthodontic extrusion is one minimally invasive therapeutic option on periodontal vertical defects reduction, esthetic reestablishment, biological width preservation and crown-root proportion maintenance, aiming future prosthetic rehabilitation. This is an alternative modality, well documented on literature, indicated for the anterior regions of the dental arch. It can be performed at a slow pace, when targeting periodontal tissue accompaniment together with tooth movement, or at a fast pace, when the goal is the root surface exposure, through reduction of gingival tissue migration. In this context, the present work presents a review based on literature about the clinical and histological aspects of orthodontic extrusion, as a mechanism for reduction of vertical periodontal alterations, as well as reporting an illustrative clinical case of the technique.