{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T14:39:08Z","timestamp":1769179148609,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>(1) Background: Orthodontic treatment may be a potential predisposing factor for ECR. The affected tooth goes to ankylosis, which could lead to a malocclusion. Although teeth severely affected by ECR (class IV Heithersay) are usually extracted, this case report aims to present the use of an ECR class IV upper canine, both as ankylosed to solve the malocclusion and the occlusal plane canting, as well as not ankylosed to correct its ridge defect with orthodontic extrusion. (2) Methods: A 14-year-old male, complaining of an ugly smile and a failed orthodontic attempt to recover an impacted canine, was referred to the orthodontic clinic. He was diagnosed with class II right subdivision, midline deviation, both upper and lower occlusal plane canting, and an upper left canine, previously impacted, showing ECR class IV. The treatment first included canting resolution with a cantilever and a spring, exploiting the anchorage offered by the ankylosed ECR canine. Then, a coronectomy, endodontic treatment, and orthodontic extrusion of that canine were performed to obtain the implant site development. (3) Results: Clinical and radiographic outcomes showed normocclusion and better bony conditions for safer implant placement in the aesthetic zone. (4) Conclusions: The high aesthetics and the periodontal and bony conditions obtained are probably not achievable by other therapeutic alternatives.<\/jats:p>","DOI":"10.3390\/dj11120278","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T03:58:02Z","timestamp":1701403082000},"page":"278","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Biomechanically and Periodontally-Based Orthodontic Treatment of a Patient with Upper Canine Affected by External Cervical Resorption (ECR): A Case Report"],"prefix":"10.3390","volume":"11","author":[{"given":"Marino","family":"Musilli","sequence":"first","affiliation":[{"name":"Private Practice, 84124 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3882-5473","authenticated-orcid":false,"given":"Morena Tina","family":"Iuorio","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Science and Oral Science, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Vaia","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Science and Oral Science, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enzo","family":"Vaia","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Science and Oral Science, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Ramaglia","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Science and Oral Science, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1695-0927","authenticated-orcid":false,"given":"Vincenzo","family":"D\u2019Ant\u00f2","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Science and Oral Science, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"ref_1","first-page":"140","article-title":"Prevalence of dental developmental anomalies: A radiographic study","volume":"24","author":"Ezoddini","year":"2007","journal-title":"Community Dent. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.ajodo.2008.07.022","article-title":"Analysis of failure in the treatment of impacted maxillary canines","volume":"137","author":"Becker","year":"2010","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"870","DOI":"10.2319\/090812-716.1","article-title":"Failure of treatment of impacted canines associated with invasive cervical root resorption","volume":"83","author":"Becker","year":"2013","journal-title":"Angle Orthod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/j.1600-9657.1988.tb00642.x","article-title":"Root resorption\u2014Etiology, terminology and clinical manifestations","volume":"4","author":"Tronstad","year":"1988","journal-title":"Dent. Traumatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1111\/iej.12942","article-title":"External cervical resorption-part 1: Histopathology, distribution and presentation","volume":"51","author":"Patel","year":"2018","journal-title":"Int. Endod. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/ejo\/cjy027","article-title":"Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): A systematic review and meta-analysis","volume":"41","author":"Samandara","year":"2018","journal-title":"Eur. J. Orthod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/j.joen.2016.06.007","article-title":"Understanding external cervical resorption in vital teeth","volume":"42","author":"Mavridou","year":"2016","journal-title":"J. Endod."},{"key":"ref_8","first-page":"115","article-title":"Factors regulating and modifying dental root resorption","volume":"88","author":"Lindskog","year":"1992","journal-title":"Proc. Finn. Dent. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1016\/j.tripleo.2007.01.020","article-title":"Clinical and scanning electron microscopic features of invasive cervical resorption in a maxillary molar","volume":"103","author":"Iqbal","year":"2007","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol."},{"key":"ref_10","first-page":"83","article-title":"Invasive cervical resorption: An analysis of potential predisposing factors","volume":"30","author":"Heithersay","year":"1999","journal-title":"Quintessence Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1708-8240.1999.tb00414.x","article-title":"Comparing the perception of dentists and lay people to altered dental esthetics","volume":"11","author":"Kokich","year":"1999","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S1073-8746(98)80017-0","article-title":"Diagnosis and treatment planning of patients with asymmetries","volume":"4","author":"Burstone","year":"1998","journal-title":"Semin. Orthod."},{"key":"ref_13","first-page":"500","article-title":"A new auxiliary spring for correction of a canted incisal plane","volume":"48","author":"Musilli","year":"2014","journal-title":"J. Clin. Orthod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.jclinepi.2017.04.026","article-title":"CARE guidelines for case reports: Explanation and elaboration document","volume":"89","author":"Riley","year":"2017","journal-title":"J. Clin. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ajodo.2005.02.031","article-title":"Class II subdivision malocclusion types and evaluation of their asymmetries","volume":"131","author":"Janson","year":"2007","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_16","unstructured":"Fiorelli, G., and Melsen, B. (1992). Biomechanics in Orthodontics Rel. 4.0 Online E-Book, IOSS GmbH."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"752","DOI":"10.2319\/0003-3219(2008)078[0752:ISDBOE]2.0.CO;2","article-title":"Implant Site Development by Orthodontic Extrusion","volume":"78","author":"Korayem","year":"2008","journal-title":"Angle Orthod."},{"key":"ref_18","first-page":"213","article-title":"Orthodontic extrusion and orthodontic extraction in preprosthetic treatment using implant therapy","volume":"12","author":"Buskin","year":"2000","journal-title":"Pract. Periodontics Aesthetic Dent."},{"key":"ref_19","first-page":"312","article-title":"The role of orthodontic extrusive remodeling in the enhancement of soft and hard tissue profiles prior to implant placement: A systematic approach to the management of extraction site defects","volume":"13","author":"Salama","year":"1993","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0889-5406(99)70284-2","article-title":"Forced eruption and implant site development: An osteophysiologic response","volume":"115","author":"Mantzikos","year":"1999","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/S0889-5406(97)70224-5","article-title":"Forced eruption and implant site development: Soft tissue response","volume":"112","author":"Mantzikos","year":"1997","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_22","first-page":"B264","article-title":"Orthodontic extrusion and implant site development","volume":"81","author":"Tomm","year":"2002","journal-title":"J. Dent. Res."},{"key":"ref_23","first-page":"222","article-title":"Controlled orthodontic extrusion with subsequent implantation","volume":"115","author":"Ostojic","year":"2005","journal-title":"Schweiz. Monatsschr. Zahnmed."},{"key":"ref_24","first-page":"775","article-title":"Orthodontic extrusion: Periodontal considerations and applications","volume":"70","author":"Bach","year":"2004","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_25","first-page":"307","article-title":"Implant site development by orthodontic extrusion of teeth with poor prognosis","volume":"37","author":"Zuccati","year":"2003","journal-title":"J. Clin. Orthod."},{"key":"ref_26","first-page":"179","article-title":"Case report: Forced eruption and implant site development","volume":"68","author":"Mantzikos","year":"1998","journal-title":"Angle Orthod."},{"key":"ref_27","first-page":"585","article-title":"Buccal and coronal bone augmentation using forced eruption and buccal root torque: A case report","volume":"23","author":"Nozawa","year":"2003","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_28","first-page":"18","article-title":"Implant site development using orthodontic extrusion: A case report","volume":"96","author":"Brice","year":"2000","journal-title":"N. Z. Dent. J."},{"key":"ref_29","first-page":"239","article-title":"Esthetic restoration with orthodontic traction and single-tooth implant: Case report","volume":"25","author":"Gaya","year":"2005","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_30","first-page":"18","article-title":"Pre-implant orthodontics: Achieving vertical bone height without osseous grafts","volume":"83","author":"Biggs","year":"2004","journal-title":"J. Indiana Dent. Assoc."},{"key":"ref_31","first-page":"40","article-title":"The development of forced eruption as a modality for implant site enhancement","volume":"90","author":"Celenza","year":"1997","journal-title":"Alpha Omegan"},{"key":"ref_32","first-page":"257","article-title":"Forced orthodontic eruption of fractured teeth before implant placement: Case report","volume":"71","author":"Chambrone","year":"2005","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_33","first-page":"274","article-title":"Forced eruption: Review and case reports","volume":"53","author":"Chandler","year":"2005","journal-title":"Gen. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1902\/jop.2006.77.1.135","article-title":"Management of interdental papillae loss with forced eruption, immediate implantation, and root-form pontic","volume":"77","author":"Lin","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_35","first-page":"621","article-title":"Immediate loading of an implant following implant site development using forced eruption: A case report","volume":"20","author":"Park","year":"2005","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_36","first-page":"923","article-title":"The orthodontic-periodontal connection in implant site development","volume":"8","author":"Salama","year":"1996","journal-title":"Pract. Periodontics Aesthet. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"185","DOI":"10.4041\/kjod.2009.39.3.185","article-title":"Orthodontic treatment of an ankylosed tooth: Application of single tooth osteotomy and alveolar bone distraction osteogenesis","volume":"39","author":"Kim","year":"2009","journal-title":"Korean J. Orthod."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s00056-009-8811-y","article-title":"Vertical periodontal ligament distraction\u2014A new method for aligning ankylosed and displaced canines","volume":"70","author":"Wilmes","year":"2009","journal-title":"J. Orofac. Orthop."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1111\/j.1600-051X.1981.tb02036.x","article-title":"Healing following surgical treatment and root demineralization in monkeys with periodontal disease","volume":"8","author":"Nyman","year":"1981","journal-title":"J. Clin. Periodontol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1038\/s41415-019-0781-x","article-title":"How to assess and manage external cervical resorption","volume":"227","author":"Patel","year":"2019","journal-title":"Br. Dent. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1111\/iej.12744","article-title":"Understanding external cervical resorption patterns in endodontically treated teeth","volume":"50","author":"Mavridou","year":"2017","journal-title":"Int. Endod. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"19","DOI":"10.25259\/APOS-9-1-4","article-title":"An archwire for non-invasive improvement of occlusal cant and soft tissue chin deviation","volume":"9","author":"Liou","year":"2019","journal-title":"APOS Trends Orthod."},{"key":"ref_43","first-page":"555","article-title":"Correction of a canted lower incisal plane","volume":"40","author":"Deluke","year":"2006","journal-title":"J. Clin. Orthod."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/S0889-5406(95)70105-2","article-title":"Biomechanics of orthodontic correction of dental asymmetries","volume":"107","author":"Nanda","year":"1995","journal-title":"Am. J. Orthod. Dentofac. Orthop."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/11\/12\/278\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:35:18Z","timestamp":1760132118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/11\/12\/278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,30]]},"references-count":44,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["dj11120278"],"URL":"https:\/\/doi.org\/10.3390\/dj11120278","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,30]]}}}