English Spanish online dictionary Term Bank, translate words and terms with different pronunciation options. La anquilosis alveolo-dentaria puede acontecer a con- secuencia de lesiones dencia de trauma dental ha aumentado significativamente durante las últimas. 12 Mar Anquilosis de la articulación temporomandibular desde Profesor asociado de Patología y Terapéutica Dental de la Universidad de Barcelona.
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Anquilosis del Primer Molar Permanente: Ankylosis is an anomaly of tooth anquulosis characterized by the fusion of cementum and alveolar bone, and may affect from small regions to the entire root surface. Clinical assessment combined with imaging exams can aid diagnosis.
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Radiographic testing enables assessing only proximal regions of possibly affected roots. Whereas cone beam computed tomography CBCT allows a three-dimensional assessment of axial, coronal, and sagittal planes of all dental extension, eliminating thus overlapping images and helping to confirm the correct diagnosis.
The present study contains a case report of a male patient with ankylosis in tooth 16 diagnosed by CBCT, aiming at providing information for dentists about this anomaly, its characteristics and situations in which CBCT should be indicated.
Dentoalveolar ankylosis is an anomaly of dental eruption, caused by mechanical failure of eruption Frazier-Bowers et al. Ankylosis can affect both sexes Silva and it is more frequent in deciduous teeth Traumatic lesions are considered the main factor for development of ankylosis Atobe et al. Moreover, these are also considered causal factors: It should also be noted that ankylosis may affect teeth that have been extracted and subsequently reimplanted Takahashi et al.
The differential diagnosis of ankylosis includes other types of eruption disorders, such as: In the impaction, the eruption is impaired due to the presence of a physical barrier or due to the ectopic position of the tooth. Primary and secondary retentions are caused by failures in the eruption mechanisms, and in the primary type, the interruption of the eruption occurs before the tooth reaches the gingival level.
The primary failure of the eruption mainly affects the posterior teeth Rhoads et al.
In such cases, the tooth may erupt partially, becoming relatively submerged or may not erupt Frazier-Bowers et al. Although there is no cement union to the alveolar bone in these cases, they present clinical features very similar to ankylosis. However, in the primary failure, the treatment is more complex, frequently involving all the teeth adjacent to the affected tooth, resulting in lateral opened bite Frazier-Bowers et al. Primary diagnosis of ankylosed teeth is made by clinical assessment through mobility and percussion tests, in these cases the tooth makes a metallic sound Campbell et al.
However, since only one third of the patients present these clinical signs Cohen-Levy et al. Although periapical x-rays are daily used in dental clinics, their value is limited for diagnosisof ankylosed teeth Paris et al. Whereas computed tomography CT is considered superior to radiography Kirziolu et al.
With equal accuracy, cone beam computed tomography CBCT can also be used for the diagnosis of ankylosed teeth Balaji, ; Hashim et al. In the initial stages, the primary failure of eruption and ankylosis may have similar clinical presentations Frazier-Bowers et al.
With the lack of accessibility of genetic tests in dental offices to confirm the occurrence of primary failure Rhoads et al. Considering the limitation in the literature concerning the diagnosis of ankylosis using CBCT Silvathe aim of this study was to provide information to dentists on the importance and the situations when to use CBCT in diagnosis of ankylosed teeth. Male patient, 16 years old was referred for clinic of the Oral Radiology to perform CBCT, in order to plan the next steps of the orthodontic treatment.
When he was referred, infraocclusion of the maxillary right first molar was reported and it dentla not respond to orthodontic forced eruption. The patient did not report anqhilosis and remembered the trauma that occurred in the region, when he was a child during a football game. The patient did not present relevant data regarding systemic situation and there were no cases in the family of infraocclusion of teeth.
Multiplanar reconstructions MPR were obtained and in the panoramic reconstruction, in sagittal and coronal planes, it was observed that in addition to unerupted teeth 18 and 28, the patient had tooth 16 partially erupted, with its roots in contact with the maxillary sinus and absence periodontal ligament space along the roots Figs.
It is possible to verify still that the distal surface of the crown of tooth 16 was in contact with the mesiocervical area of tooth 17, causing external resorption. The hypodense image identified in the occlusal surface is a dental sental affecting enamel and dentine Fig. Comparing clinical signs, symptoms and CBCT image, the hypothesis of dental ankylosis was suggested, because infraocclusion of tooth 16 was below the contact area of the teeth 17 and 15 Fig.
The ethics committee on human research exempted this study approval since only CBCT images would be disclosed without the possibility of patient identification. Infraocclusion of tooth 16 in anquilosie with the maxillary sinus white arrow. A Distobuccal and palatal root and B Mesiobuccal root.
Use of bone extraction tool. Ankylosis is defined as the anatomical fusion of cementum with alveolar bone Loriato et al.
Ankylosis is a common complication after traumatic episodes Atobe et al. Although the incisors teeth are more susceptible to ankylosis after a trauma Cohen-Levy et al.
Besides, another peculiarity of the present case is that ankylosis occurred with a permanent tooth, because it rarely affects permanent dentition Atobe et al. As observed in the case reported, the more evident clinical sign of ankylosis is the presence of infraocclusion Anquilowis et al.
In the present case, as in the primary eruption failure, a posterior tooth was affected. However, unlike the primary failure, normal eruption of adjacent teeth was observed. Besides, the CBCT exam confirmed the presence of ankylosis in the roots of the teeth.
Thus, once the crown of the tooth was below the point of contact of teeth 17 and 15, it was suggested that the ankylosis occurred early in the phase of the eruption process during the patient’s childhood.
Therefore, depending anqjilosis the level of infraocclusion, it may trigger several clinical implications during jaws development and growth, e. Moreover, because the cementum of the ankylosed tooth is in direct contact with the alveolar bone, its root is more susceptible to suffer bone resorption by replacement Takahashi et al.
Another problem identified in our case report was the presence of resorption of the crown of tooth 17, probably caused by pressure exerted by tooth Ankylosis treatment depends on infraocclusion degree. In slight cases, follow up is recommended Lim et al.
When infraocclusion is less than 5 mm, it is possible to carry out restorative treatment with the use of restorative materials or prosthetic crowns for reestablishing dental occlusion Lim et al. On the other hand, if the infraocclusion is severe, the treatment is more complex and has the following options: Although in adults ankylosis treatment is less challenging due to the possibility of rehabilitation with prosthesis or anquilosjs Mohadeb et al.
It is worth mentioning that surgical extraction often causes bone defects in the alveolar area affected by ankylosis Lim et al. In anquilosid present case report, the close relationship of tooth 16 roots with the floor snquilosis the maxillary sinus may also hinder their surgical extraction and lead to complications such as oroantral communication. According to Lin et al.
However, ankylosis early diagnosis is difficult, for in the beginning areas absence periodontal ligament are small and the tooth still presents mobility Cohen-Levy et al. Besides, percussion clinical tests and metallic sound produced are only reliable in about one-third of the cases Cohen-Levy et al. Moreover, radiographic examination is anquilosls inaccurate Kirziolu et al. Also, it is not possible to visualize the root bifurcation area Silva. In the present case, because the tooth was a molar tooth, radiographic diagnosis is even more challenging, for it is a multiradicular znquilosis due to overlapping structures.
Hence, ankylosis diagnosis may occur incidentally, when the patient undergoes an orthodontic treatment and the tooth does not respond to orthodontic movement Takahashi et al. In order to be acknowledged with the subject, we made a research in the PubMed database, using the following key words: Studies on diagnosis of ankylosis using CT are limited Kitai et al.
However, for identifying the root region extent and exact location where ankylosis is present, the examination by three-dimensional imaging is essential Paris et al.
In complex cases, CBCT may also be required for surgical treatment of ankylosed teeth Balajiwhen the tooth is near noble structures, e.
CBCT is therefore an important diagnostic tool for examination and treatment planning Balajisafe for professionals and patients as well.
The importance of the early diagnosis of ankylosis should be highlighted, because the maxillomandibular growth turns the orthodontic and surgical treatments more complex, due to the worsening of occlusal problems and deficiencies of the alveolar bone.
In this context, the CBCT imaging allows identified with high accuracy all root surfaces affected by ankylosis and it may be requested for accurate diagnosis of the presence and location of ankylosis in molar teeth, showing anatomical details that could not be visualized in conventional radiographic techniques because aanquilosis their two-dimensional nature and overlapping structures.
Diagnosis and treatment of severe dentoalveolar ankylosisin primary molars: Severe lateral open bite caused by multiple ankylosed teeth: Submerged mandibular carious deciduous second molar along with an impacted second premolar associated with denal atypical inflammatory follicular cyst: Diagnosis of ankylosis in permanent incisors by dentql ratings, Periotest and digital sound wave analysis.
Orthodontic treatment of an ankylosed maxillary central incisor through single-tooth osteotomy by using interdental space regained from microimplant anchorage. Ankylosis of permanent first molars: A case report of a discordant twin pair. A comparative study for image quality and radiation dose of a cone beam computed tomography scanner and a multislice computed tomography scanner for paranasal sinus imaging.
Primary failure of eruption: A case report with 10 years follow-up. Conebeam computed tomography in orthodontics: Terminology and manifestations of eruption disturbances. Use of dentomaxillofacial cone beam computed tomography in dentaal.
Anquilosis de la articulación temporomandibular – Espidident
Three-dimensional evaluation of a rare case with multiple impacted teeth using CT. Value of computed tomography CT in imaging the morbidity anquilosix submerged molars: Treatment of ankylosed mandibular first permanent molar.
Orthodontic treatment of severe anterior open bite and alveolar bone defect complicated by an ankylosed maxillary central incisor: Late diagnosis of dentoalveolar ankylosis: Impaction and retention of second molars: A retrospective followup study. Effectiveness of decoronation technique in the treatment of ajquilosis Dental ankylosis diagnosed by CT with tridimensional reconstructions. Management of a severely submerged primary molar: Treatment of ankylosis of the mandibular first molar with orthodontic traction immediately after surgical luxation.
Establishing the diagnostic criteria for eruption disorders based on genetic and clinical data. An atypical presentation of mechanical failure of eruption of a mandibular permanent molar: Indications of cone beam CT in head and neck imaging. Orthodontic treatment of a traumatically intruded tooth with ankylosis by traction after surgical luxation.