Treatment of a severely ankylosed central incisor and a missing lateral incisor by distraction osteogenesis and orthodontic treatment

Ankylosis is the fusion between the mineralized root surface and the alveolar bone. Tooth trauma is a common etiologic cause of ankylosis. In young patients, the ankylosed teeth fail to erupt along with the remaining alveolar process during vertical facial growth, resulting in submerged teeth and defects in the alveolar process. Extraction of the ankylosed teeth followed by prosthetic replacement is a common option for treatment. This case report presents the treatment of a woman with an anterior open bite and an ankylosed central incisor due to replantation of a traumatized tooth. We treated this ankylosed central incisor with subapical osteotomy and distraction osteogenesis for better tissue regeneration. After active orthodontic treatment and prosthetic restoration, her open bite was corrected, and she had a harmonious smile line. (Am J Orthod Dentofacial Orthop 2010;138:829-38)