Comparison of restorative treatment methods in teeth without ferrule

 
Introduction: The term “severely damaged tooth” refers to teeth that have lost portions of their crown structure due to primary root fracture factors, caries lesions, cervical resorption, or other causes, and this reconstruction has brought them many challenges. Studies have shown that the ferrule effect and the presence of 1.5 – 2 mm of supragingival dental tissue can be useful in increasing fracture resistance.
Article description: A severely damaged tooth can be preserved through procedures such as crown lengthening (CL), orthodontic extrusion, surgical extrusion, or a more conservative method such as deep margin elevation (DME). CL was recommended for aesthetic enhancement, subgingival caries exposure, fracture exposure, or a combination of these. In some clinical situations, a combination of orthodontic extrusion and fibrotomy may also be an option, but this method cannot be used if the tooth is ankylosed or hypercementousis, or if the root has a vertical fracture, severe internal or external resorption, a short length, untreated periodontitis, or periapical disease. Also, the use of surgical extrusion is suggested because it is fast and has the least discomfort for the patient. However, it does not have one universal protocol and can increase the risk of ankylosing and root resorption as a result of periodontal fiber trauma. As a conservative method, DME can extend the ferrule length and reduce the subsequent impression methods and cementation processes.
Conclusion: Studies indicate that there are various methods for obtaining adequate ferrule in severely damaged teeth, such as extending the tooth outside the alveolar bone or directing the structures around the tooth in an apical direction, or adding to the tooth structure, to make a suitable platform for the placement of the restoration margin.