J Dent Rehabil Appl Sci.  2017 Jun;33(2):143-153. 10.14368/jdras.2017.33.2.143.

Managements of ankylosed incisor occurred during adolescence using alveolar bone distraction osteogenesis and decoronation: case report

• Kwon EY
• Son WS
• Park SB
• Kim SS
• Kim YI
• Choi YK

• KMID: 2388021
• DOI: http://doi.org/10.14368/jdras.2017.33.2.143

Abstract

One of the common complications of dental injury is tooth ankylosis. Unlike adults, when tooth ankylosis occurs in the adolescents, ankylosis interfered the growth of the adjacent alveolar bone, resulting in the developmental failure of the alveolar bone and subsequent open bite. The most common treatment option for ankylosed tooth is extraction. However, when prognosis of ankylosed tooth after extraction is expected to be poor due to severity of infrapositioning or prosthetic replacement cannot be performed immediately, various treatment options should be considered. This report suggests multidisciplinary treatment that might bring functionally and esthetically favorable result included alveolar bone distraction osteogenesis and decoronation of ankylosed maxillary anterior tooth with orthodontic and prosthetic treatments.

Keyword

ankylosed tooth; infraocclusion; alveolar bone distraction osteogenesis; decoronation

MeSH Terms

Adolescent*
Adult
Ankylosis
Humans
Incisor*
Open Bite
Osteogenesis, Distraction*
Prognosis
Tooth
Tooth Ankylosis

Figure

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  Fig. 1 (A) Pretreatment extraoral and intraoral photographs (1st treatment). The patient was 11 years old. (B) #21 was ankylosed and located infraocclusionly more than 8 mm due to trauma at 7 years. Anterior open bite was observed.

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  Fig. 2 (A) Pretreatment lateral cephalograph, periapical and panoramic radiographs (1st treatment). (B) Lamina dura of #21 was disappeared in radiographic. (A - C) #21 was located infraocclusionly

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  Fig. 3 Intraoral appliance for #21 distraction osteogenesis after single tooth osteotomy. Distraction was carried out 0.5 - 1.0 mm per day.

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  Fig. 4 Posttreatment intraoral photographs, panoramic and periapical radiographs (1st treatment).

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  Fig. 5 (A, B) Follow-up (after 6 years) photographs, panoramic and periapical radiographs. The external root resorption on #21 was occurred. (C - G) The vertical position of #21 was infraocclusion and pink spot of cervical area was observed.

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  Fig. 6 Intraoral photographs during orthodontic treatment (2nd treatment).

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  Fig. 7 Procedure of decoronation. (A, B) In order to create new marginal bone, the coronal part of the root surface was removed 2 mm below the marginal bone (C). The crown part of #21 was adjusted and placed like an artificial tooth.

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  Fig. 8 Extraction of the root rest and GBR procedure. (A, B) Remaining buccal alveolar bone thickness was too thin. (C) Guided bone regeneration procedure was performed on buccal area with bovine bone material and collagen membrane. (D, E) The crown part of #21 was used like an artificial tooth and adjusted to alveolar crest contour.

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  Fig. 9 After 6 months of GBR operation, implantation of fixture. (A, B) Procedure of implant placement. (C) The crown part of #21 was adjusted to alveolar crest contour. (D, E) Post-operative panoramic radiograph and standard periapical radiograph.

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  Fig. 10 (A - C) Posttreatment extraoral and intraoral photographs. The final prosthetic restoration of #21 was performed. (D, E) Posttreatment panoramic radiograph and lateral cephalograph.

Reference

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