Ankylosed Tooth| Diagnosis & Treatment of Teeth Ankylosis
Ankylosis of the teeth is most often encountered by people with an incomplete dentition. This defect causes significant inconvenience to patients and makes them feel complex about their smile.
Key Points of Article
- What is an ankylosed tooth?
- Ankylosis of teeth in children
- Teeth ankylosis symptoms
- Causes of the appearance of dental ankylosis
- Diagnosis ankylosis
- Ankylosis treatment
- Temporomandibular joint ankylosis
What is an ankylosed tooth?
Tooth ankylosis is a pathology characterized by fusion of the cement of the tooth with the jaw bone. The dental root loses part of the ligamentous apparatus, which often leads to adhesion or sprouting of bone tissue.
The aesthetics of the teeth are disturbed, they look shorter and change the angle of inclination. Ankylosis usually occurs during the eruption of the dentition. Also, pathology can form at a late stage in the formation of the dental arch. It's important to know. The process is accompanied by periodontal necrosis and the incorporation of root cement into the alveolar bone.
Ankylosis of the milk tooth is caused by the loss of the periodontal ligament. It is observed in cases where the milk molar does not fall out due to the lack of a permanent dental unit. Ankylosed teeth differ in size from the neighboring ones, so a bite correction will be required.
Tooth ankylosis is a serious oral disease characterized by fusion of the tooth root with the tissues of the alveoli - a depression cavity in the gum where the root of the tooth is located. Such processes lead to the death of the periodontium and the inclusion of the cement of the tooth root directly into the alveolar bone.
The result of the development of ankylosis is the incorrect location of the tooth: it is lower than those that are located nearby, while the latter also begin to grow incorrectly, bending their position.
Wearing braces in this case will not bring the desired result, because due to the absence of a periodontal ligament, the tooth is so firmly adhered to the bone tissue that the angle and position of the braces will not change.
If the ankylosis happens in many teeth, the bite is so curved that the patient sometimes cannot even close the jaw normally.
Often healthy opponent teeth also suffer - those which are located on the opposite side. As a result of the absence of a chewing load, they become weak, loosened, and in severe forms, they may even fall out.
Ankylosis of teeth in children
Separately, there is dental ankylosis of the milk tooth in children, in which the temporary tooth does not fall out on its own, interfering with the normal growth and development of the molar. In some cases, the milk tooth cannot develop normally, erupting only partially, as a result of which the molar also lags behind in development.
Teeth ankylosis symptoms
With ankylosis of the teeth the level of tooth remains below the adjacent ones, which, as a rule, are tilted to the side towards the ankylosed tooth.
A child has a delay in the eruption of a milk or molar tooth, sometimes accompanied by their deformation or eruption in the wrong position.
In some cases, a partially erupted tooth may still be covered with soft tissues: not only will it not be able to perform the chewing function normally, but it will also cause the appearance of pathogenic microflora in the oral cavity due to food particles accumulating in the gingival gap.
Dental ankylosis not only delays the eruption and development of teeth, but also worsens the condition of the jaw system as a whole, especially if the course of the disease has already distorted the bite.
Causes of the appearance of dental ankylosis
The vast majority of cases of the disease are of genetic origin, that is, parents with similar problems have a very high chance of having children who will also have ankylosis. Such children are recommended to conduct a more frequent preventive examination with a dentist in order to identify the appearance of ankylosis in the early stages and to eliminate its consequences in a timely manner.
Pre-existing dental diseases.
Ankylosis can develop as a result of periodontal disease, as well as hypodentia - the absence of one or more teeth. In this case, the development of ankylosis is not limited to childhood or adolescence and is often found in adult patients.
Some cases are traumatic in nature: bone fusion of the dental root with the alveolar tissue occurs against the background of partial or complete dislocation of the tooth, which led to the death of the periodontium. Chemical attack. The use of preparations containing resorcinol-formalin in pediatric dentistry can lead to disruption of the root resorption process and subsequent delay in the replacement of temporary teeth with permanent ones.
To identify ankylosis and make a diagnosis, the dentist not only listens to the patient's complaints and examines the oral cavity, but also conducts a number of additional studies that can detect the disease at the earliest stages and prevent deterioration. Due to the complexity of the pathology, it is advisable to carry out diagnostics in conjunction with a professional orthodontist.
The initial examination allows you to assess the degree of pathology and its effect on the adjacent teeth, bite. Percussion. Tapping the teeth with fusion gives a more sonorous sound, since the dead periodontium does not dampen acoustic vibrations.
X-ray. Allows you to identify ankylosis that developed after the eruption of a tooth.
CT scan. It is necessary to determine the reasons for the development of dental fusion, the presence of bone bridges. A concomitant goal of diagnostics is to cut off other diagnoses that are similar in symptomatology to ankylosis: cementomas, osteomas, various anomalies in the development of hard tooth tissues.
The treatment strategy entirely depends on the nature and degree of fusion and is determined individually in each case. In some cases, when the problem tooth does not interfere with the development of adjacent teeth and does not create bite defects, expectant tactics are indicated with periodic re-examination by the attending physician.
If a cosmetic or functional defect is present, an intervention is necessary, which can be conservative or surgical. The first is successfully used to treat ankylosis of primary teeth, which are covered with thin-walled crowns. This not only provides aesthetic appeal, but also ensures the normal eruption of the tooth without disturbing the occlusion and deformation of the dentition.
In case of ankylosis of the molar, the intervention of a surgeon is carried out, which removes the coronal part and increases the height of the tooth by building up with a cement or any other filling mass. In advanced cases, when the tooth interferes with the neighboring ones, deforms the dentition and the resorption of the roots is unstoppable, tooth extraction is recommended.
The effectiveness of therapeutic and surgical procedures largely depends on the timely treatment of the patient with an appropriate complaint. Remember, tooth root ankylosis is a complex disease that requires close attention from the attending physician, and you should not let it go by itself or try to cure it yourself.
Temporomandibular joint ankylosis
Ankylosis of the TMJ can occur as a complication of arthritis, infectious diseases, as a result of trauma or prolonged forced immobility of the joint. In the early stages of development, ankylosis is asymptomatic and manifests itself after the final death of the articular cartilage.
Ankylosis of traumatic origin develops rather quickly. As the articular cartilage degenerates, the articular surfaces gradually fusion.
With fibrous ankylosis, limitation of joint mobility is accompanied by pain, with bone ankylosis, there is no pain. Against the background of progressive ankylosis, the development and growth of the lower jaw slows down, the eruption of permanent teeth, and the facial skeleton is deformed. Patients have malocclusion, breathing, diction, and atrophy of the masticatory muscles.
Ankylosis of the TMJ can be unilateral or bilateral. Treatment of ankylosis depends on the stage of development and the severity of the disease. The main goal of the treatment is to restore the mobility of the jaw and the functionality of the dentition.
In most cases, osteotomy and placement of an artificial temporomandibular joint head are performed. After the operation, the patient is prescribed mechanotherapy, if necessary, orthodontic and orthopedic treatment.
- Etiopathogenic hypotheses on dental ankylosis
- Interventions for treating traumatised ankylosed permanent front teeth
- Ankylosis of permanent teeth: a case report and literature review
- Management of ankylosed primary molars with premolar successors: a systematic review
- Ankylosis of deciduous teeth
- Effectiveness of decoronation technique in the treatment of ankylosis: A systematic review
- Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review