Treatment of an Avulsed and Ankylosed Incisor through Single Tooth Alveolar Osteotomy and Conventional Orthodontic Mechanisms

Abstract

We present the treatment of an injured and avulsed incisor (which was afterwards ankylosed), by subapical osteotomy and conventional orthodontic mechanisms. A 9-year-old boy presented for orthodontic treatment with an injured and avulsed central incisor, which, after initial repositioning, ended up with ankylosis and severe root resorption. The case was treated by single tooth alveolar osteotomy and distraction osteogenesis through conventional orthodontics, advocating for the floating bone concept due to the short vertical distance by which the tooth alveolus part had to be relocated. Orthodontic treatment of the avulsed central incisor was completed after osteotomy and distraction osteogenesis, and the tooth was restored to its proper position, aiming to address issues of aesthetics and function for the time being. The patient was finally referred to a prosthodontist for future and final implant rehabilitation due to severe root resorption. Distraction osteogenesis after surgical procedures is a reliable solution for dealing with an ankylosed and submerged tooth.

Treatment of anterior open bite and an ankylosed incisor by applying multiloop edgewise archwire, mini-implants, and dentoalveolar distraction

“…15,18 A single-incisor dentoalveolar distraction was reported by Isaacson et al 19 and others. 1,3,7,9,13,16,[20][21][22][23][24][25][26]29 DO consists of 3 sequential periods: latency, distraction, and consolidation. The latency periods varied considerably for different case reports from 4 days to 2 weeks.…”

“…The single-tooth osteotomy block can be distracted by various methods, such as vertical extrusion bends, 4,5,7,19 vertical elastics, 21,22 a coil spring or loop, 5 a nickel-titanium wire, 5,7,15,16,19,[23][24][25] or a distraction device. 3,9,20,26 The advantages of using a distraction device are that the displacement of the dentoalveolar block gradually increases in precise amounts and that the patient can activate the distractor at home.…”

“…When growth is complete, there are several surgical treatment protocols to extrude an ankylosed tooth, such as single-tooth osteotomy, 4,13,14 surgical luxation, [15][16][17][18] corticotomy, 8 and distraction osteogenesis (DO). 1,3,7,9,13,16,[19][20][21][22][23][24][25][26] DO using distraction devices has become one of the most predictable treatment methods for ankylosed teeth. Kinzinger et al 27 applied a bone-borne distraction device which used adjacent alveolar bone as a source of anchorage.…”