Management of ankylosed teeth using the decoronation technique: integrative literature review and case report.

INTRODUCTION: The decoronation technique has been described in literature since 1984 and, based on the available results, it can lead to considerable benefits for the repair and rehabilitation of ankylosed teeth. Based on these reports, one could expect that this procedure would be well known by the dental community. However, this fact does not seem to be true, and this procedure is not widely used. METHODS: The objective of this paper is to present appropriate literature that discusses decoronation and evaluate the perspectives of the procedure, both in relation to the technique and the long-term benefits for the patient. An integrative literature review at PubMed, ScieELO, and Lilacs databases was performed using the keywords "decoronation", "ridge preservation decoronation", "decoronation ankylosis". In addition, a case report will be presented to demonstrate the technique in a systematic and detailed manner. RESULTS: Considering the inclusion criteria, 27 articles that present consistency regarding decoronation were selected. CONCLUSION: There is scarce availability of scientific works related to the topic, to corroborate and discuss the technique. The present paper reinforces the benefits of this procedure, and revisit decoronation, attempting to provide a possible treatment for ankylosed teeth in growing patients.

Interdisciplinary treatment of ankylosed upper central incisors with an anterior vertical ridge defect: A case report.

This case report describes the successful 10-years interdisciplinary treatment of ankylosed upper central incisors with an anterior vertical ridge defect. This treatment was challenging as ankylosis was present before the growth spurt. Orthodontic treatment in association with decoronation, a xenogeneic bone graft, an autogenous sub-epithelial connective tissue graft, and implant placement were performed to correct the vertical ridge defect and to re-establish appropriate function, gingival health, and aesthetics. Decoronation performed during the growth spurt was the key to avoiding alveolar ridge deformity.

Decoronation followed by dental implants placement: fundamentals, applications and explanations.

Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported.

Decoronation followed by dental implants placement: fundamentals, applications and explanations

ABSTRACT Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported.

RESUMO Áreas dos maxilares com dentes em anquilose alveolodentária e reabsorção dentária por substituição podem ser consideradas como portadoras de osso normal, em pleno processo fisiológico contínuo de remodelação; e os implantes osseointegráveis podem ser aplicados com sucesso. A remodelação óssea promoverá sua osseointegração, independentemente de haver raízes em anquilose e/ou em reabsorção por substituição. Após 1 a 10 anos, todos os tecidos dentários terão sido substituídos por osso. O local, a angulação e o posicionamento ideal no espaço para se colocar o implante devem ser ditados pela conveniência clínica associada, exclusivamente, ao planejamento prévio. Uma das vantagens da decoronação com colocação imediata de implantes em dentes anquilosados e com reabsorção por substituição é a manutenção do volume ósseo na região, tanto vertical quanto horizontalmente. Se possível, deve-se preservar, na preparação da cavidade para o implante, a parte vestibular da raiz, mesmo que fina; isso deixará os tecidos gengivais com aspecto de plena normalidade por longos períodos. O importante na seleção de casos para a decoronação é a ausência de contaminação microbiana na região, representada por lesões periapicais crônicas, presença de fístula, fraturas radiculares antigas não consolidadas e doença periodontal avançada ativa. Essas situações são contraindicações para a decoronação. A ocorrência de anquilose alveolodentária e reabsorção por substituição sem contaminação não deve mudar o planejamento para instalação de implantes, nem mesmo os critérios de escolha do tipo e marca de implante dentário a ser utilizado. Nunca foi relatado fracasso na decoronação e uso de implantes dentários.

Management of ankylosed maxillary canine with single-tooth osteotomy in conjunction with orthognathic surgery.

Ankylosis of teeth is the abnormal adherence of alveolar bone to dentin or cementum. Ankylosis of a submerged maxillary canine can be challenging when striving for an optimal occlusal and esthetic treatment outcome with orthognathic surgery. If an ankylosed tooth does not respond to orthodontic forces, surgical procedures may be indicated to facilitate movement of the tooth to the correct position including a single-tooth segmental osteotomy to reposition the alveolar bone including the ankylosed tooth. The objective of this case report is to describe the treatment of a patient with an ankylosed submerged maxillary right canine, with a single-tooth osteotomy performed to reposition the tooth into its correct position concomitant with double-jaw orthognathic surgery and TMJ surgery.

Attempted traction of impacted and ankylosed maxillary canines.

The aim of this article is to report the clinical orthodontic treatment of an adult patient with 2 impacted maxillary canines. Traction was applied to the impacted teeth; however, after 7 months, the teeth were found to be ankylosed and were extracted. The extraction spaces were closed by moving the posterior teeth mesially with mini-implant anchorage. The results were satisfactory, with the premolars in the functional position of the canines.

Treatment of ankylosis of the mandibular first molar with orthodontic traction immediately after surgical luxation.

The aim of this article was to report a clinical case of orthodontic treatment in a patient with Class II malocclusion and ankylosis of a maxillary first molar. Surgical luxation was performed, followed immediately by traction with an orthodontic arch with straps. The results obtained were satisfactory, and occlusal equilibrium was improved.

Congenital agenesis of premolars associated with submerged primary molars and a peg-shaped lateral incisor: a case report.

The combination of infraoccluded primary molars and agenesis of the permanent successors is rare. This condition progresses with increased severity since the primary teeth do not usually exfoliate spontaneously. The clinical examination of an 11-year-old girl revealed 4 submerged primary second molars, agenesis of all second premolars, and a peg-shaped maxillary lateral incisor. Treatment in this case was surgical extraction of the submerged teeth and placement of removable appliances to maintain space and vertical dimension.

Anquilose alvéolo-dentária em molares decíduos: revisão de literatura e apresentação de casos clínico-cirúrgicos / Ankylosis in primary molars: a review of literature and presentation of clinical cases

Os autores apresentam revisão de literatura sobre anquilose dentária na dentição decídua e relatam dois casos clínicos com tratamento cirúrgico: um em paciente jovem com descoberta precoce da anquilose dos dentes 75 e 85, tratado clinicamente com colocação de dispositivo em resina composta para manutenção da oclusão, sem sucesso e com subseqüente submersão do dente e outro, em paciente adulto, sem tentativa de tratamento clínico e com submersão do dente 55 e giroversão do 15 erupcionado

Tratamento orto-cirúrgico da mordida aberta com anquilose: relato de um caso / Treatment orthodontic and surgical of cross bite with ankylosis

A anquilose dentoalveolar é uma anomalia que se traduz por fusão anatômica entre o dente e o osso alveolar. Sua prevalência é maior na dentição decídua, onde o dente anquilosado assume uma posição de submersão, que varia de acordo com a gravidade do caso. Contudo, quando ocorre em dentes permanentes, sem alteração significativa de altura, seu diagnóstico torna-se mais difícil, podendo mascarar uma anomalia dento-facial e retardar a conduta clínica racional. Frente a essa dificuldade, o presente artigo relata um caso severo de anquilose, abordando todos os aspectos, desde o diagnóstico até o tratamento orto-cirúrgico utilizado

Anquilose da ATM: tratamento cirúrgico por interposição de enxerto muscular livre / TMJ ankylosis: surgical treatment by interposing free muscle draft

O autor sugere uma solução para resultados mais eficazes, nas condilectomias para tratamento das anquiloses das articulações temporomandibulares uni ou bilaterais. Após revisão bibliográfica das intervenções que pudessem evitar as recidivas da anquilose, resumindo as parafernálias e simplificando os meios utilizados, com o menor trauma cirúrgico, considerando também a necessidade do uso de próteses para movimentação mandibular no pós-operatório, desenvolveu-se uma técnica que pelos resultados obtidos passa a ser considerada como alternativa válida técnico-cirúrgica