A patient has a maxillary canine with a failed root canal treatment that needs retreatment. The tooth has a subgingival fracture that extends BELOW the level of the crestal bone on the facial surface. The root has adequate length. What is the most appropriate FIRST step to make this tooth restorable?

When a fracture margin is below the alveolar bone level on an ANTERIOR tooth in the esthetic zone, two options exist to make it restorable: Crown lengthening (osseous surgery) removes bone to expose the fracture margin, but on an anterior tooth this requires significant bone removal, compromises adjacent tooth support and periodontal health, and creates esthetic problems with altered gingival levels and potential gingival asymmetry. Orthodontic extrusion applies controlled orthodontic forces to gradually erupt the tooth, bringing the fracture margin supragingivally WITHOUT removing bone. The bone and soft tissue follow the tooth (maintaining normal architecture). For ANTERIOR teeth with adequate root length, orthodontic extrusion is PREFERRED because it preserves bone, maintains gingival symmetry, and produces superior esthetic outcomes. Crown lengthening is more appropriate for posterior teeth, short roots, or when orthodontic extrusion is not feasible.