Effectiveness of decoronation technique in the treatment of ankylosis: A systematic review

Abstract

-Background: Dentoalveolar ankylosis in growing patients is complex leading to continuing root replacement resorption, tooth infraposition, or may even affect the development of alveolar ridge and adjacent teeth. While extraction of ankylosed teeth might be associated with bone loss, decoronation of the offending tooth (removal of crown portion and instrumentation of pulp canal to stimulate bleeding) has been suggested as a more conservative approach of bone preservation until definitive implant placement is planned. Objective: To primarily assess the efficacy of bone width and height preservation around ankylosed permanent teeth following decoronation. METHODS: Pubmed, Embase, Ovid Medline, Thomson's ISI Web of Science and Cochrane library were searched from the year 1984 up to May 2015. Two authors conducted the data extraction. To eliminate publication bias, Open Grey literature and Pro-quest Dissertation Abstracts and Thesis database was also consulted. Results: Through our strict selection criteria, only 12 articles were considered for eligibility. No randomized controlled trials were identified. Only one retrospective cohort study, four case series and seven case reports, were analyzed. Conclusions: Following decoronation, preservation of ridge height and ridge width were both noted. To maximize the benefits of decoronation, a timely and wellmonitored intervention is required.

Esthetic and functional management of an ankylosed central incisor with a conservative restorative approach

“…A radiographic‐only diagnosis has beenreported in only 20% of the cases . The affected tooth has an atypical eruptive process, resulting in various sequela ranging from a mild localized infra‐position of the tooth to a more severe presentation that can present an un‐esthetic ridge deformity and migration of the adjacent teeth into the space …”

Ankylosis of Permanent First Molar: Diagnosis by Cone Beam Computed Tomography

“…Dentoalveolar ankylosis is an anomaly of dental eruption, caused by mechanical failure of eruption (Frazier-Bowers et al, 2007), characterized by the fusion of cementum and alveolar bone (Loriato et al, 2009;Pithon & Bernardes, 2011;Chae & Paeng, 2012;Guimarães et al, 2015;Mohadeb et al, 2016), with destruction of the periodontal ligament (Pithon & Bernardes;Lin et al, 2014) and gradual replacement by bone tissue (Alves et al, 2011;Bertl et al, 2012;Silva, 2015).…”

“…Traumatic lesions are considered the main factor for development of ankylosis (Atobe et al, 2009;Cohen-Levy et al;Chae & Paeng;Gault et al, 2013;Lin et al;Mohadeb et al;Silva). Moreover, these are also considered causal factors: metabolic disorders, local deficiency in vertical alveolar bone growth (Atobe et al; Loriato et al; Cohen-Levy et al; Alves et al; Parisay et al; Lin et al; Guimarães et al), failure of eruption force (Alves et al), genetic factors (Atobe et al; Cohen-Levy et al; Chae & Paeng; Lin et al; Guimarães et al; Silva), focal inflammation/infection, chemical/thermal irritants (Cohen-Levy et al; Gault et al; Parisay et al; Silva), and soft tissue pressure (Atobe et al; Cohen-Levy et al).…”

“…Primary diagnosis of ankylosed teeth is made by clinical assessment through mobility and percussion tests, in these cases the tooth makes a metallic sound (Campbell et al, 2005;Lim et al, 2008;Berl et al, 2012;Gault et al;Lin et al;Mohadeb et al;Silva), unlike healthy teeth, in which the sound is neutralized by periodontal ligament (Berl et al, 2012;Parisay et al;Silva).…”

“…Although periapical x-rays are daily used in dental clinics, their value is limited for diagnosisof ankylosed teeth (Paris et al, 2010;CohenLevy et al;Berl et al, 2012;Cha et al, 2012;Gault et al;Lin et al;Mohadeb et al), because ankylotic areas only visible when it is present in proximal surfaces of the root, not being possible to identify lingual/palatal and buccal surfaces (Takahashi et al;Cohen-Levy et al;Berl et al 2012;Silva et al). Besides, in this examination the presence of ankylosis becomes evident only when at least 20 % of the root surface is affected (Campbell et al; Cohen-Levy et al; Mohadeb et al).…”