1 / 61

Ankylosis & Retained Primary Teeth

Ankylosis & Retained Primary Teeth. Lecture 5 Ingrid Reed DDS, MS Dept. of Orthodontics & Dentofacial Orthopedics. Images: http://www.dditions/dentaentistryportal.com/dental-conl-ankylosis.html. Objectives. Be able to diagnose ankylosis Be able to manage treatment of an ankylosed tooth

thor
Télécharger la présentation

Ankylosis & Retained Primary Teeth

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Ankylosis & Retained Primary Teeth Lecture 5 Ingrid Reed DDS, MS Dept. of Orthodontics & Dentofacial Orthopedics Images: http://www.dditions/dentaentistryportal.com/dental-conl-ankylosis.html

  2. Objectives • Be able to diagnose ankylosis • Be able to manage treatment of an ankylosed tooth • Be able to distinguish between delayed eruption and a retained tooth • Guide eruption of permanent dentition

  3. ankylosis

  4. Definition • Dentoalveolar ankylosis is an eruption anomaly defined as the union of the tooth root to the alveolar bone, with local elimination of the periodontal ligament, and cessation of eruption • Continued vertical alveolar growth and eruption of adjacent teeth

  5. Clinical diagnosis • Infraocclusion – marginal ridges uneven • Percussion – different sound on tapping • Ankylosed tooth • Sharp solid sound (>20% of root fused) • Mobility testing • Lack of orthodontic movement • Radiographs

  6. Dental implications • Ectopic eruption • Tipping of adjacent teeth • Loss of arch perimeter • Periodontal compromise/problems • Supraeruption • Complications with extraction of ankylosed teeth

  7. prevalence • 1.3 % -14% • Ankylosis of anterior primary teeth related only to trauma • The primary second molar is the most commonly ankylosed tooth • Mandibular ankylosis is twice as common as maxillary

  8. Causes of ankylosis • Trauma – especially permanent teeth • Unknown – primary teeth • Theories • Familial pattern • Genetics • Metabolic disturbances

  9. Treatment options • Observation • Extraction • Orthodontic treatment • Considerations • Absence or presence of successor tooth • Amount of infraocclusion • Dental age /root formation • Complications

  10. AH

  11. AH

  12. Patient AH

  13. JH Age 9 years 9 mo

  14. JH

  15. JH

  16. JH

  17. JH

  18. JH

  19. Radiographs

  20. JH Extraction complications

  21. Extracted teeth

  22. 11 months post extraction

  23. Brother NH 7 years 1 month

  24. DF

  25. MC

  26. Ankylosed with no successor • Problems • Long term periodontal problems • Loss of alveolar bone • Difficult extraction • Treatment – depends on crowding • Extract – move teeth at least partially into edentulous space – create new bone – reposition later • Extract – close spaces orthodontically

  27. Ankylosed 1°- Missing second premolars

  28. Consequences of infraocclusion of a deciduous molar

  29. Ankylosed primary molar

  30. Ankylosis – Permanent tooth pages 671- 673 • Implant planned, can’t align ankylosed tooth • If extract – alveolar atrophy if growth not complete • “Bank” alveolar bone - remove crown, retain root – fill with calcium hydroxide • Root resorbs over 3-5 year • Alveolar bone remains • Implant more successful without need for graft • Pontic placed on archwire or removable appliance • Implant placed when vertical growth is complete

  31. Retained primary teeth

  32. Age 8 years 1month

  33. Chronological age : 13yrs 3mo Dental age : 10.5 – 11 yrs

  34. 2nd primary molar Palatal root

  35. Over-retained vs. Delayed Eruption

  36. Age: 12 years 4 months

  37. Retained Primary Tooth

  38. Space Maintainers • Distal shoe • Band loop • Hayes Nance • Transpalatal bar • Lower lingual arch

  39. Best space maintainer

  40. Distal Shoe

  41. Band or Crown & Loop

  42. Hayes Nance

  43. Lower Lingual Arch

  44. Space Maintenance Design Factors • Anchorage • Status of succedaneous teeth • Eruption status of other teeth • Medical status • Cleansability • Patient cooperation/abilities • Need to use as active appliance

More Related