Korean J Orthod.  2009 Jun;39(3):185-198. 10.4041/kjod.2009.39.3.185.

Orthodontic treatment of an ankylosed tooth; application of single tooth osteotomy and alveolar bone distraction osteogenesis

• Kim YI
• Kim SS
• Son WS
• Park SB

• KMID: 2273213
• DOI: http://doi.org/10.4041/kjod.2009.39.3.185

Abstract

Tooth anklylosis is defined as the adhesion state of alveolar bone to dentin or cementum. Trauma, disturbed metabolic disease, and congenital disease have been given as etiologic factors. Complications of tooth ankylosis are tipping of the neighboring teeth, space loss, and supraeruption of the opposing teeth. Particularly if dental ankylosis occurs in maxillary incisors of a growing child, the ankylosed tooth can not move vertically with subsequent disturbance in vertical growth of the alveolar process. With an appropriate treatment approach, an esthetic condition must be achieved especially in the maxillary anterior region. In this report, two cases are presented which were treated by the surgical repositioning method. One is treated by alveolar bone distraction osteogenesis which used a tooth-borne type distraction device and the other by single tooth osteotomy.

Keyword

Ankylosed tooth; Single tooth osteotomy; Alveolar bone distraction osteogenesis

MeSH Terms

Alveolar Process
Child
Dental Cementum
Dentin
Humans
Incisor
Metabolic Diseases
Osteogenesis, Distraction
Osteotomy
Tooth
Tooth Ankylosis

Figure

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  Fig. 1 Facial and intraoral photographs and panoramic, standard and cephalometric radiographs before treatment. Maxillary right first premolar, canine, lateral and central incisors showed infraocclusion.

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  Fig. 2 Tooth separation test for differential diagnosis of tooth ankylosis using elastic module. A and B, Tight contact existed between maxillary right central, lateral incisors and canine; C and D, central incisor was separated; E and F, lateral incisor was separated.

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  Fig. 3 Intraoral photographs of tooth borne type distractor.

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  Fig. 4 Interdental and subapical osteotomy.

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  Fig. 5 Latency period and distraction procedure. A, Latency period for 5 days; B, 1 mm/day for 4 days; C, D, 0.5 mm/day for 8 days.

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  Fig. 6 Fine adjustment using NiTi archwire.

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  Fig. 7 Finishing.

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  Fig. 8 Facial and intraoral photographs and panoramic, standard and cephalometric radiographs after orthodontic treatment.

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  Fig. 9 Final results after gingival graft (A) and all ceramic crown restoration (B).

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  Fig. 10 Facial and intraoral photographs and panoramic, occlusal and cephalometric radiographs before treatment. Maxillary left canine was impacted.

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  Fig. 11 Progress of orthodontic traction of impacted canine using cantilever spring and indirect anchorage. Orthodontic micro-implant anchorage was splinted to the first molar by 0.019" × 0.025" SS wire. A, Inserting cantilever spring; B, after 1 month; C, after 4 months.

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  Fig. 12 Surgical luxation and immediate orthodontic traction.

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  Fig. 13 Surgical repositioning of upper left canine by single tooth osteotomy. A, Flap design; B, incision; C, flap elevation & bone contouring; D, E, fixation by miniplate.

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  Fig. 14 Canine and bone block were adjusted using archwire. A, 1 week after single tooth osteotomy; B, 2 weeks after single tooth osteotomy; C, fine adjustment.

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  Fig. 15 Photographic and radiographic films at post-treatment.

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