Objectives: To present and compare several extrusion techniques in case of insufficient tooth structure to create a sufficient ferrule and consider the biological width.
Clinical considerations: Extrusion methods based on orthodontic or surgical techniques are commonly applied, well-described, and predictable extrusion methods. Elastics with the highest possible tensile forces, magnets, or orthodontic appliances (e.g., braces) can be used for orthodontic approaches. These procedures are minimally invasive and the extrusion distance to be achieved depends on the forces applied. For the surgical extrusion method, a vertical extraction system is used, and respective teeth are placed in a more coronal position within one appointment. The correct selection of the extrusion method depends on various factors, including inter alia the condition of the periodontal tissues and of the adjacent teeth, as well as the experience and preference of the clinicians. Nevertheless, the presented treatment options require a high level of patients compliance.
Conclusions: Various extrusion techniques enable saving and restoring teeth with severely damaged crowns. They appear to deliver satisfying treatment results with low complication rates, even in the esthetic area. Medium-term follow-up data up to 5 years of the concepts are partially available and promising; results on long-term data are still pending.
Keywords: forced orthodontic extrusion; forced surgical extrusion; magnetic extrusion; orthodontic extrusion ferrule design; restorative dentistry; surgical extrusion; tooth preservation.
© 2025 The Author(s). Journal of Esthetic and Restorative Dentistry published by Wiley Periodicals LLC.