NESHEENA V K 3RD Year Roll No: 9

ANKYLOSIS OF TEETH

Definition

The union of a tooth root to the alveolar bone due to the lack of periodontal ligament space.

ANKYLOSIS ankyl- adhesion, fixed-osis - a process, condition, or state, usually abnormal or diseased .

Submerged teeth are deciduous teeth that have undergone variable degree of root resorption and then have become ankylosed to bone

Ankylosis occurs due to anatomic fusion of cementum or dentin with alveolar bone. Unerupted permenent teeth may become ankylosed by enostosis of enamel

Ankylosis of teeth is uncommon, but more in the deciduous teeth than permanent teeth.

Ankylosis of deciduous teeth ("submerged teeth") . The most commonly affected tooth is the mandibular second deciduous molar. Partial root resorption first occurs and then the tooth fuses to the bone. This prevents normal exfoliation of the deciduous tooth and typically causes impaction of the permanent successor tooth

Etiology Changes in local metabolism

– that will lead to Ankylosis of tooth in some cases

Familial pattern TraumaInfectionAbnormal tongue pressure and

other causes

Clinical featureAge; it is more commonly in

second decade of lifeCommonly affected teeth are

deciduous first and second molar , following by anterior teeth

Exfoliation and subsequent replacement by permanent teeth is prevented due to Ankylosis

Characteristic solid sound in contrast to dull, cushioned sound of normal tooth on percussion.

Development of malocclusion, local periodontal disturbances and dental caries occurs

Teeth lack mobility even after root resorption

Failure of the tooth to move after orthodontic forces

It may cause malposition of adjacent teeth

• Such as, creating space for adjacent teeth to tip mesially or distally on top of the shortened tooth

• Super-eruption of opposing teeth

The tooth appears sunken compared to the occlusal plane.

Radiographic FeaturesPartial absence of periodontal

ligament. A break in continuity of PDL , indicating an area of ankylosis is usually evident

Loss of lamina Dura

TreatmentIf a primary tooth was ankylosed

and no permanent teeth • if onset early -> extraction is

recommended with placement of a space maintainer.

• If the onset is late , can build up with composite to occlusal plane & maintain contacts appropriately

If permanent teeth is present

• Surgical extraction

. Ankylosis itself is not a reason to remove a permanent tooth, however teeth which must be removed for other reasons are made significantly more difficult to remove if they are ankylosed

• Build up with restorative material to maintain contacts

If a permanent tooth is ankylosed

Opposing teeth should never be allowed to

supra eruption .

If ankylosis occurs in multiple teeth a segmental alveolar bone osteotomy and bone graft may be needed

• Textbook of oral pathology SHAFER 8TH edition.

• Textbook of Oral Pathology  By Anil Ghom, Shubhangi Mhaske• Internet – Dr. G’S TOOTHPIXAsk an orthodontidic.com & IBIMA

Publishing