Ankylosed maxillary incisor with severe root resorption treated with a single-tooth dento-osseous osteotomy, vertical alveolar distraction osteogenesis, and mini-implant anchorage

Anterior tooth autotransplantation: a case series

Tooth autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. It is relatively common for the anterior segment of the mouth to be affected by traumatic tooth injuries, impacted and/or congenitally missing permanent teeth. Autotransplantation of teeth into the anterior dental arch can provide unrivalled biological solutions when such issues arise in this critical aesthetic zone, particularly for adolescent patients. The combination of meticulous pre-surgical assessment, synergistic interdisciplinary collaboration and carefully performed anterior tooth autotransplantation has been demonstrated to achieve impressive outcomes, with respect to both transplant survival and clinical success. © 2023 Australian Dental Association.

Camouflage Correction of Skeletal Class III Severe Open Bite with Tooth Ankylosis Treated by Temporary Anchorage Devices: A Case Report

Tooth ankylosis is a disorder characterized by the fusion of tooth and alveolar bone. This case report describes the treatment of a severe open bite due to tooth ankylosis. A 14-year-old female patient with a chief complaint of masticatory dysfunction was diagnosed with skeletal Class III severe anterior open bite and tooth ankylosis. She visited our university hospital with a chief complaint of an anterior open bite. After the surgical luxation of the ankylosed maxillary right central incisor, the tooth was orthodontically retracted using a nickel-titanium wire. The right mandibular lateral incisor and canine were luxated and retracted using intermaxillary elastics from a temporary anchorage device (TAD), which was inserted in the opposite jaw. During the treatment, skeletal Class III malocclusion deteriorated due to anterior growth of the mandible. Therefore, TADs were inserted into the retromolar pad on both sides of the mandible and retracted into the mandibular dental arch. Although the mandibular right canine was luxated several times, it could not be brought to the occlusal line, and was thus extracted; the extraction space was replaced with a prosthesis. Consequently, a normal overjet and overbite with a straight profile were achieved. Extrusion of ankylosed teeth by intermaxillary elastics from a TAD is a valid treatment option for patients with severe open bites.

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.

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

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.

Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: A case report

The ankylosis of permanent incisors is usually caused by trauma. In a growing patient, the ankylosed tooth fails to move along with the vertical growth of the remaining alveolar process, which results in an infraoccluded tooth, gingival margin disharmony and unaesthetic smile.This case report presents an 23-year-old female patient whose maxillary right central incisor (tooth number 11) had been traumatised eight years earlier. A vertical discrepancy of about 4 mm was exhibited between teeth 11 and 12. To reposition the crown and gingival margins of the ankylosed tooth to an ideal level, single-tooth dento-osseous osteotomy and distraction of the block of bone containing the tooth was planned. In order to separate the roots of adjacent teeth for opening a space for osteotomy incision, fixed orthodontic treatment with multibracket appliances was initiated on her maxilla. After five weeks, a single-tooth dento-osseous osteotomy was performed using a piezoelectric device. To move the tooth in occlusal and buccal directions, two temporary anchorage devices (miniscrews) on her mandible and interarch elastics were applied. Approximately three weeks later, the ankylosed tooth successfully had an ideal position-relative to the adjacent teeth-and a harmonious gingival margin was achieved by minor gingivoplasty on all incisors.

Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics

Ankylosed teeth may have a significant esthetic and functional impact especially at the anterior segment of the upper arch. Treatment of ankylosed teeth is challenging. The objective of this case report is to describe a clinical case in which an ankylosed tooth was treated with the use of osteogenic distraction associated with simplified orthodontic biomechanics. A 17-year-old female Caucasian patient presented with a Class II malocclusion, severe maxillary dental crowding, moderate mandibular dental crowding, anterior open bite, upper midline deviation to the right, and upper right central incisor in infraocclusion due to ankylosis. Treatment involved the use of the ankylosed tooth as anchorage for the distalization of the right upper segment to correct the Class II malocclusion and to create space prior to surgery. After one week of surgical osteotomy, traction of the tooth and bone segment was initiated with the use of intermaxillary elastics. The ankylosed tooth was moved to the desired position. Bone formation and mucogingival tissue adaptation were observed. Thus, esthetic and functional improvement was achieved. Osteogenic distraction associated with simplified orthodontic biomechanics is an alternative to the treatment of ankylosed teeth which can replace the use of distractor screws, making treatment simpler and more accessible.

Use of alveolar distraction osteogenesis for anterior maxillary defect reconstruction

Alveolar osteogenic distraction (AOD) is a biological process through which new bone formation occurs between bone segments that are gradually separated by incremental traction. This case report described the oral rehabilitation with dental implants of a patient with a vertical bone defect in the maxillary anterior region using the AOD technique. The patient presented with absence of the teeth 22, 21, 11, and 12 associated with a vertical bone defect. The AOD was performed using a supported osteodistractor device surgically installed with subsequent daily activations. After 21 days, the ideal positioning of bone fragment was confirmed and activation was ceased. Five months after the initial surgery, two dental implants were installed in the region of teeth 12 and 22. An FP3 metal–ceramic prosthesis was installed offering satisfactory esthetic results. In conclusion, the use of AOD to increase the alveolar ridge was effective and ensured rehabilitation with dental implants.

Effectiveness of a Piezoelectric-Assisted Distraction Osteogenesis Procedure for the Treatment of Ankylosed Permanent Front Teeth

A common complication of tooth replantation after traumatic avulsion is tooth ankylosis causing dental malpositioning, partial loss of function, tipping of adjacent teeth and worsening of aesthetics. The aim of this study is to evaluate the effects of a repositioning procedure of such ankylosed permanent front teeth by a distraction osteogenesis procedure. Five patients (mean age 13.4 years), with an ankylosed permanent front tooth in the anterior area, were enrolled in the present study. After the pre-operatory orthodontic preparation, each selected site was treated with single-tooth dento-alveolar block osteotomy surgery performed with a piezoelectric surgery device with ultrasonic cuts on the buccal side. Subsequently, a custom distraction device, made by a resin splint and a sector expansion screw, was set in such a way it delivered a force with direction and sense towards the planned position of the tooth as well as the osteotomy's incision. After a latency period of 14 days, the distraction of the dento-alveolar block was started with a rate of distraction of 0.8 mm per day. The average shift obtained by the ankylosed teeth was 7.8 ± 0.75 mm (±SD), and the ankylosed tooth was regularly positioned into the occlusion in 20.4 ± 1.85 days (±SD), with a slight relapse (±0.5 mm) observed after 1 year. This study indicates that a therapeutic approach combining piezoelectric surgery and orthodontic therapy may be useful for the treatment of ankylosed permanent teeth in the frontal area with a long-term follow-up over 5 years.

Single-tooth dento-osseous osteotomy with a computer-aided design/computer-aided manufacturing surgical guide

This clinical note introduces a method to assist surgeons in performing single-tooth dento-osseous osteotomy. For use in this method, a surgical guide was manufactured using computer-aided design/computer-aided manufacturing technology and was based on preoperative surgical simulation data. This method was highly conducive to successful single-tooth dento-osseous segmental osteotomy.