Surgical Extrusion With Rotation For Complex Crown-Root Fractures: Cases

Complicated crown-root fractures frequently result from dental trauma. While severely compromised teeth often require extraction, select cases can be preserved through surgical extrusion. This technique offers advantages over orthodontic extrusion (shorter duration) and crown lengthening (reduced osteotomy), yet evidence remains limited. We present a case series evaluating 180° rotational surgical extrusion, highlighting its technical merits. Five patients (18-37 years) with anterior crown-root fractures underwent: Preoperative root canal therapy; Minimally invasive root luxation; 180° intra-alveolar rotation and repositioning; Fiber-reinforced splinting (2 months); Prosthetic rehabilitation (post-and-core crown); Follow-up included clinical/radiographic assessments at 2, 6, and 12 months. Results: All cases exhibited; Periodontal healing by 2 months (bone formation radiographically confirmed). Six months and one year after the operation, the teeth were re-examined and no obvious loosening was found. The gums showed no recession or hyperplasia, and no significant external absorption of the tooth roots was observed. After rotating and re-implantation, both the labial and lingual ends are located above the gingiva. This method has a short traction distance and better stability. Besides, when the tooth rotates within the alveolar socket, the activity of periodontal ligament cells is protected, which may increase the probability of periodontal ligament healing and reduce the occurrence of root external resorption. The surgical traction operation is minimally invasive, with a short treatment cycle, high success rate of periodontal ligament healing, and good short-term follow-up results.