Personalized Post-Core Orthodontic Traction For Subgingival Residual Roots

This case introduces a novel multidisciplinary strategy for the restoration of subgingival residual roots, integrating personalized post-core design with orthodontic traction. This minimally invasive approach avoids bone resection, optimizes crown-root ratios, and enhances aesthetics through controlled biomechanical forces. A 29-year-old male presented with a 3-mm subgingival fracture of the right maxillary central incisor and underwent root canal therapy. Subsequently, a custom cast metal post-core with an orthodontic traction hook was placed. Adjacent teeth were bonded with 3M ultra-thin brackets and ligated with NiTi archwires. Periodontal ligamentotomy was performed to initiate elastic traction, achieving 2-mm supragingival root extrusion after 2 months. Following this, a secondary ligamentotomy preceded a 1-week retention period. The prosthodontist then adjusted the post-core, removed the hook, and prepared the abutment for an all-ceramic crown. The restoration demonstrated perfect marginal adaptation, with 1-year follow-up confirming stable retention, healthy gingiva, and normal periapical tissues. This method differs from conventional techniques by enabling restorative-driven traction device design, allowing precise torque application and directional control. Enhanced fragment management optimizes biomechanics for subsequent prosthetics. This approach integrates root traction with post-core restoration, enabling customized post-core systems based on fracture position and restorative needs. It improves traction precision, reduces costs, shortens treatment duration, and enhances outcomes.