Laser Verses Conventional Circumferential Supracrestal Fiberotomy in Orthodontic Extrusion for Crown Lengthening

Laser Verses Conventional Circumferential Supracrestal Fiberotomy in Orthodontic Extrusion for Crown Lengthening: A Randomized Controlled Clinical Trial

The aim of this study is to the evaluate the stability of the amount of healthy tooth structure exposed after laser versus conventional technique of fiberotomy during orthodontic extrusion.

Parallel groups, two arm, superiority Randomized Controlled Clinical Trial, with 1:1 allocation.

PICO:

Population: patients with endodontically treated teeth and short clinical crown that require crown lengthening in the esthetic zone Intervention: laser fiberotomy with orthodontic extrusion Control: conventional fiberotomy using blade with orthodontic extrusion

Outcomes:

Primary outcome: Stability of the mount of healthy tooth structure exposed.

Secondary outcomes:

• Stability of gingival Margin reference.
• Stability of the alveolar bone.
• Rate of tooth extrusion.
• Sulcus depth.
• Pain Time: 8 weeks after retention

Inclusion Criteria:

• Age between 18 and 50 years old
• Teeth in the esthetic zone
• Restorable teeth with successful endodontic treatment
• Adjacent teeth with clinical attachment of at least two-thirds of the root length, thus permitting adequate support for orthodontic movement
• Crown root ratio after extrusion of the needed ferrule amount not less than 1:1

Exclusion Criteria:

• Patients with bad oral hygiene or Periodontally affected teeth
• Uncontrolled diabetic patients
• Pregnant females
• Medications that could affect tooth movement (bisphosphonate) radiation therapy less than 2 years
• Moderate-to-heavy daily smokers (who report consuming at least 11 cigarettes/day)
• Teeth with periapical inflammation, ankylosis or vertical root fracture
• Teeth with probability of furcation exposure after extrusion.
• The level of the root is 3 mm or more apical to the level of the bone