Contemporary Clinical Dentistry | Apr-Jun 2013 | Vol 4 | Issue 2 243 Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement rafael scaf de Molon, Érica dorigatti de aVila 1 , joão antonio chaVes de souza, andressa Vilas boas nogueira, carolina chan cirelli 2 , rogerio Margonar 3 , joni augusto cirelli Abstract Forced orthodontic eruption (FOE) is a non‑surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft‑tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inlamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft‑tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant‑supported restoration. Keywords: Bone remodeling, forced eruption, multidisciplinary treatment, orthodontic extrusion Departments of Diagnosis and Surgery, 1 Dental Materials and Prosthodontics, and 2 Orthodontics, School of Dentistry at Araraquara, Univ Estadual Paulista - UNESP, 3 Department of Health Sciences, Discipline of Periodontology and Integrated Clinic, University Center of Araraquara - UNIARA, Araraquara, São Paulo, Brazil Correspondence: Dr. Rafael Scaf de Molon, Department of Diagnosis and Surgery, Univ Estadual Paulista - UNESP, Rua Humaitá, 1680, 14801-903 Araraquara, São Paulo, Brazil. E-mail: molon.foar@yahoo.com.br Introduction The presence of an unsatisfactory recipient site caused by alveolar ridge resorption in result of periodontal disease makes unfeasible the ideal 3‑dimensional implant position in the anterior maxilla. In addition, the gingival contour follows the osseous crest resulting in severe esthetic problems that compromise subsequent prosthetic restoration. Thus, the replacement of a compromised anterior tooth by a dental implant remains one of the most difficult challenges for the dentists. [1] In these situations, different surgical techniques such as guided tissue regeneration, [2] bone and connective graft procedures, [3,4] distraction osteogenesis, [5] and ridge splitting [6] have been widely used in clinical practice to increase the amount of available bone and/or gingival tissue at the potential implant site and improve implant esthetic and/or anchorage. Instead of surgical traditional techniques, another approach to improve the 3‑dimensional topography of the implant recipient site is the forced orthodontic eruption (FOE). This is a non‑surgical treatment that aims to obtain hard and soft‑tissue formation at potential implant sites, extruding orthodontically hopeless teeth and their periodontal apparatus. [7] Among the advantages of this technique are: Leveling of isolated infrabone defects, lengthening the clinical crown, repositioning of the gingival margin, improvement of primary anchorage of a dental implant and increased amount of attached gingiva and bone. [7] This bone and gingival augmentation improves the recipient implant site for a more esthetical restoration. During the orthodontic extrusion, mechanical stresses exerted onto the alveolar bone led to activation of angiogenic growth factors, which would contribute to the formation of new support tissue: Gingival and periodontal fibers, and deposition of new bone via osteoblastic activity at the alveolar crest. [8] As tooth movement occurs in the coronally direction, the gingiva and the bone attached by the periodontal ligaments migrate in the same direction of the movement, resulting in a coronal shift of the bone at the base of the defect. FOE can also promote augmentation of soft‑ tissue volume through the increasing of the attached gingival. The only requirement for the satisfactory application of this procedure is that the apical third of the root must maintain an intact fiber apparatus and the patient should not present systemic problems such diabetes mellitus that impairs the Access this article online Quick Response Code: Website: www.contempclindent.org DOI: 10.4103/0976-237X.114876 [Downloaded free from http://www.contempclindent.org on Thursday, November 07, 2013, IP: 177.183.166.222] || Click here to download free Android application fo this journal