Ankylosis of Traumatized Permanent Incisors: Pathogenesis and Current Approaches to Diagnosis and Management

Ankylosis is a known complication of replanted or severely intruded permanent incisorsand can be diagnosed by the characteristic sound emitted when the tooth is tapped. Theankylosed incisor demonstrates a lack of physiologic mobility and, later, radiographic evidenceof replacement resorption. If the patient is pre-adolescent or adolescent at the timeof trauma, infraocclusion relative to adjacent teeth will become apparent during jawgrowth. Despite considerable knowledge about the pathogenesis of ankylosis garneredfrom animal studies and observation of human replanted teeth, there is no known treatmentto arrest this condition. Management techniques and rehabilitation options foraddressing ankylosis and its consequences are supported by little evidence, do not appearto be widely adopted and do not offer any proven long-term benefit. Avulsion and severeintrusion of permanent incisors are rare injuries. Should the decision be made to interveneby replantation or reduction of the intrusion, the clinician must be prepared to diagnoseankylosis, identify its negative consequences and develop treatment plans accordingly.