Surgical Extrusion with 180° Rotation: Case Report Shows 4 Year Stability
In a clinical case report published in Dental Tribune ASEAN, a group of clinicians describe a technique known as surgical extrusion with 180° rotation as a viable method to preserve a severely compromised anterior tooth. They report a four-year follow-up during which the treated tooth remained stable, functional, and aesthetically acceptable. Dental Tribune ASEAN
The patient in question had sustained trauma to the maxillary left central incisor, resulting in an oblique crown fracture extending below the gum line. Upon radiographic and clinical assessment, there was insufficient tooth structure remaining to reliably support a restoration. After considering various options, the clinicians opted for surgical extrusion. The procedure involved carefully loosening the tooth’s periodontal ligament via syndesmotomy and luxation, then extruding the tooth by about 6 mm and rotating it 180°. The rotation was intended to reposition healthy periodontal ligament fibers into areas where bone was deficient and to minimize the amount of extrusion required. Dental Tribune ASEAN
Following repositioning, the tooth was stabilized using a flexible splint for approximately three weeks, during which time a non-surgical retreatment, fiber post placement, and coronal build-up were performed. Over the months and years, the tooth was assessed clinically and radiographically. At the 2-year mark, there was evidence of periapical healing and vertical bone gain, particularly on the distal bone crest. At the full four years, the tooth remained asymptomatic, nonmobile, and fully functional, showing no signs of root resorption, pathology, or periodontal breakdown. Dental Tribune ASEAN
The authors emphasize that surgical extrusion with rotation offers several advantages over other more invasive or time-consuming techniques like orthodontic extrusion or aggressive crown lengthening. It is relatively simple to perform, cost-effective, and offers faster restoration times, with favorable esthetic results. However, they also caution about possible risks such as root resorption, marginal bone loss, tooth mobility, or ankylosis, especially if the procedure is not executed with optimal care. Dental Tribune ASEAN
In conclusion, the long-term success in this case suggests that surgical extrusion with 180° rotation can be an effective and conservative option for preserving damaged anterior teeth, provided that the clinician carefully plans, executes, and monitors healing over time. Dental Tribune ASEAN
📖 Original Article Information
Title: Surgical extrusion with 180° rotation: A case report with four-year follow-up
Source: Dental Tribune ASEAN / Dental Tribune International, published 25 September 2025