I Was Told I Needed an Implant Because My Front Tooth Was Broken—Can It Be Saved with Orthodontic Treatment?｜An Actual Prosthodontic-Orthodontic Case

Hello, this is Apgujeong Orthodontic Clinic, Yonsei Baro Dental Clinic.

Q. My front tooth is broken. Do I absolutely need an implant?

Hello, this is Apgujeong Orthodontic Clinic, Yonsei Baro Dental Clinic.

There are cases where people visit a dentist after breaking a front tooth and receive the diagnosis:

> “The tooth must be extracted and replaced with an implant.”

However, not every case necessarily leads to an implant.

Depending on the location of the fracture and the condition of the surrounding gums and bone, it may be possible to preserve the natural tooth through orthodontic treatment.

Today, I would like to introduce an actual prosthodontic-orthodontic case in which a patient was diagnosed as needing an implant but was able to preserve their own tooth through orthodontic treatment.

Q. What is prosthodontic orthodontic treatment?

Prosthodontic orthodontic treatment is not simply a procedure to straighten teeth.

It refers to orthodontically repositioning a damaged tooth so that prosthetic treatment can be performed.

In particular, when:

• the tooth is broken below the gumline

• decay has progressed deeply

• there is still a possibility of saving the tooth

The tooth can be orthodontically pulled upward, followed by crown treatment.

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This patient visited us wondering whether there might be a way to save and use the tooth through orthodontic treatment before extracting it and immediately receiving an implant.

Because the tooth was broken at the root, it could not be restored with a crown in its current condition, leaving extraction as the only option. However, if the tooth is orthodontically pulled upward from within the bone through extrusion, it can be restored with a crown and preserved.

The broken tooth had also become dark and discolored, causing the gum to appear dark in places. This could also be concealed to some extent through orthodontic treatment.

When the root of the tooth is pushed backward, the gum covering it becomes correspondingly thicker, making the dark color less visible.

We began orthodontic treatment by attaching a Clippy-C appliance to the upper teeth to facilitate movement of the tooth roots, and an MTA appliance for simple partial orthodontic treatment to the lower teeth, which had irregular alignment.

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Orthodontic treatment was carried out with a temporary tooth placed over the broken tooth and a Clippy-C appliance attached.

Usually, when a tooth is extruded from the jawbone, the gum also follows it downward.

Therefore, in the photograph taken six months later, the blue arrow shows that the gum had grown downward considerably along with the tooth, making the tooth appear about half as short as it did initially.

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Gum contouring was performed to remove the gum that had grown down excessively.

After restoring the original gumline,

The tooth was carefully prepared, and crown restoration was begun to match the color of the adjacent teeth.

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The final crown was placed successfully.

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At some point in life, anyone may face a situation in which a tooth needs to be extracted.

This may be due to an injury or decay, but the important thing is to visit a nearby orthodontic clinic before proceeding directly with an implant and discuss with an orthodontic specialist whether there is a way to preserve and continue using your own tooth.

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I hope this was helpful to those who were curious.