Seoul Sinsa Station [Rev Dental Clinic] The Final Treatment for a Front Tooth with Only the Root Remaining: Orthodontic Extrusion (Limited Orthodontics) + Crown

Hello.

I am Baek Won-seon, Director of Rev Dental Clinic at Sinsa Station.

I would like to show you a valuable and proper treatment process that you might otherwise only see in a textbook.

It is called orthodontic extrusion—a name that is difficult enough to say.

This was a treatment received by a fellow dentist. It was possible because the patient had a very high level of understanding of the treatment. ^^

The final treatment to try one more time instead of an implant when a front tooth—especially an upper front tooth—that has undergone multiple treatments is reduced to only its root!

This patient was a woman in her 40s who came in because her front tooth had broken.

You might think, “Doesn’t she still have a fair amount of tooth remaining?”

Yellow line: outline of the tooth root; green line: trace of the broken front-tooth fragment

As you can see in the photo on the left (it is almost at a cyborg level), a family dentist of the patient, who is also a dentist, had placed a post inside the front tooth and forcibly built the tooth back up with resin.

(It is difficult even to explain.)

That part broke again and became loose, which was why she came in.

The photo on the right was taken after removing the fragment that had been dangling from the green area.

In dental terms, this was a crown-root fracture, and because the fracture line extended too deeply, extraction seemed necessary.

We took a CT scan to extract the tooth and place an implant immediately, but...

We performed a simulated surgery on the CT scan to see whether we could extract the tooth and place an implant, but there was less bone available than expected.

There was barely enough bone to accommodate the thinnest implant.

Since the patient is a fellow dental professional—and even a dentist in the same specialty—placing an implant felt quite burdensome.

Let’s perform orthodontic extrusion, try to preserve the remaining root one more time, and then proceed with crown treatment!

I borrowed a paper and brought over only the photographs.

The idea is roughly this: attach orthodontic appliances, gently bring the short remaining root slightly out of the gum, place a post, and make a crown.

For anyone who graduated from dental school through the standard program, this is an ideal treatment that no one would be unfamiliar with. However, these days, when implants are showing sufficiently good performance, there are very few dentists who choose a treatment that takes approximately 3–6 months.

Since the patient was a dentist, we decided to work through it carefully together.

It may look as though there is still some tooth remaining, but on closer inspection, only the post and resin are left.

We need to attach orthodontic appliances, right?

Dr. Hwang Woo-chan, Director of the Orthodontics Department, attached them beautifully.

Our patient made the decision on the same day without hesitation.

Brackets were attached only to the six front teeth.

The disadvantage is that wearing them makes you look like someone undergoing orthodontic treatment. However, one advantage is that resin can be added to the tooth with only a root remaining, making it look as though a tooth is present. (!)

These days, having orthodontic appliances attached is not particularly unusual~~ And although having a temporary tooth that looks a little unattractive can be a drawback, it is still hard to overlook the benefit of having one~~ haha

We expected the root to emerge approximately 3–4 mm and allowed about 4–5 months.

We took an X-ray approximately once a month, like this.

Compared with the tooth immediately to the right, you can get the sense that the root is gradually emerging outward. Haha

It looked roughly like this!

In fact, by adjusting the pulling speed during orthodontic extrusion, it is possible to bring out only the tooth, or to bring it down while pulling the surrounding tissues along with it (and inducing their formation).

After 4.5 months of treatment, we confirmed that the tooth was not loose, placed a post, completed a resin core, and fabricated a crown.

This photo was taken after treatment was completed.

It is a little difficult to tell which tooth was the one that had been broken, isn’t it?

The quality of front-tooth treatment at Rev Dental Clinic at Sinsa Station is quite good.

Please scroll up or down and take a look at the before-and-after photos below. Haha

When viewed from below, you can see the tooth that received crown treatment.

The patient was extremely satisfied!

Left: before orthodontic extrusion; right: after post and crown treatment following orthodontic extrusion

I put a lot of effort into making this front-tooth crown.

It was finished beautifully, without being noticeably different from the surrounding teeth! I hope it is not just me who thinks so.

The photo on the left is definitely before treatment, and the one on the right is after treatment!

At the six-month follow-up, we also confirmed that the patient was using it very well.

There are several treatment methods for a front tooth with only the root remaining.

1. Crown lengthening: The gum is reshaped to expose more of the root, and a crown is placed.

-> The disadvantage is that it is difficult to apply to front teeth, where appearance is important. It is a method used broadly for molars.

2. Surgical extrusion: The front tooth is carefully extracted, fixed in a slightly extruded position, and allowed to heal naturally.

-> The root needs to be relatively healthy so that it can be extracted successfully. If it breaks during extraction, the procedure cannot proceed. It can also be somewhat painful, and the area must be left without a temporary tooth while it stabilizes.

3. Extraction and implant placement: This is the most straightforward and common solution, but it means losing your natural tooth and can be difficult to use in the front-tooth area, where there is fundamentally less bone.

4. Orthodontic extrusion: This method can be used in most cases involving a front tooth with only the root remaining. As you saw above, one advantage is that the space can be filled with something made to look like a temporary tooth.

*** However, the remaining root must not be too short. The tooth may be loose after treatment is complete. Other disadvantages include the long treatment period of approximately 3–6 months and the additional cost of orthodontic treatment. There also needs to be a certain number of surrounding teeth to which the orthodontic appliances can be attached, right? Haha

---

There is no treatment plan that is perfect in every respect, nor is there one that is simply wrong.

If a relatively young patient has a broken front tooth, but the root is longer and more worth preserving than expected,

and the patient does not have a strong objection to orthodontic treatment, orthodontic extrusion can be an excellent treatment plan!

These days, with implants having become extremely common, people often look back on and discuss more traditional dental treatments.

Orthodontic extrusion is realistically difficult to use for large molars, but it can often be used for premolars!

If someone is reading this post, feel free to leave any questions in the comments.

I wanted to explain what orthodontic extrusion is, so I made a careful record of it in this post. ^^

Treatment start date: 2025.10.27

Treatment completion date: 2026.04.04

Expected complications: Secondary caries, periodontal disease, etc.

About the medical team