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Article: Volume 42 Number 1 Page 44 - January/February 2015

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  Dent Update 2015; 42: 44-50

Restorative/Orthodontic/Paediatric Interface:  Challenges in Treating Traumatically Intruded and Ankylosed Permanent Incisors: A Case Report with a Multidisciplinary Approach

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Abstract: This report discusses the challenges, complications and management of traumatic intrusion injuries affecting the permanent dentition. A case is described where trimming of the incisal edge of a severely intruded and ankylosed upper lateral incisor resulted in an unexpected re-eruption of the tooth. It is suggested that the vibrations from drilling may have disrupted the ankylosis, initiating spontaneous re-eruption and this approach could provide a minimally invasive and conservative pathway to treating ankylosed teeth.

Clinical relevance: To date no effective treatment has been described to reverse the development of replacement root resorption leading to the loss of the affected tooth. The hypothesis proposed here suggests that mechanical vibrations, if strong enough, may disturb the ankylosis and allow re-eruption of the intruded tooth.

Author notes: Serpil Djemal, MRD RCS, FDS RCS, MSc, BDS, Consultant in Restorative Dentistry, Head of Restorative Dentistry and Traumatology, Teresa Kärki, BDS, Senior House Officer and Gavin Mack, MOrth, MFDS RCS, BDS, Consultant in Orthodontics, King’s College Dental Institute, Caldecot Road, London SE5 9RW, UK.

Objective: To recognize the challenges in treating traumatically intruded and ankylosed permanent incisors using a multidisciplinary approach.