Decoronation of Ankylosed Teeth in Adolescents
1 Describe the mechanism for infraocclusion of ankylosed teeth in adolescents.
2 Describe options for eliminating or reducing the infraocclusion subsequent to ankylosis.
PERIODONTAL LIGAMENT PATHOLOGY AND ITS ROLE IN TOOTH ERUPTION
The eruption process during adolescence is dependent upon a normal and intact periodontal ligament. In cases of ankylosis normal eruption cannot take place, which creates a problem that can be severe in young patients, leading to progressive infraocclusion. This can also occur in adults where slow continuous eruption usually takes place.207 The following periodontal ligament systems are essential for normal continuous eruption: an intact periodontal ligament structure (Sharpey’s fibers), cervical periosteal fibers (green) that ensure alveolar vertical bone growth during the eruption process, and interdental ligament fibers (red) that maintain a slight interdental ‘compressive’ force between adjacent teeth.