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| Sometimes
the roots don't dissolve properly, and instead they fuse directly
to the jawbone. The fusion may occur because the ligament that normally
surrounds the tooth in the jawbone is lost. This condition is called
ankylosis. |
| The
causes for ankylosis vary; for example, the healthy ligament cells
may dry up and die because of: |
#
Inflammation or infection
# Problems with metabolism or normal bone growth
# Congenital tendencies
# Gaps in the membranes around the tooth
# Abnormal pressure from the tongue
# Crushing or other damage |
| Ankylosis
also may develop in children or adults when an injury (such as with
sports or accidents) causes the top of the tooth to be broken off,
leaving the roots behind. |
| Some
studies have indicated that 1 to 3 percent of children may have
ankylosis with one or more primary teeth, while other studies have
indicated more than 38 percent of children may have ankylosis. Studies
also have shown that children or adolescents with 1 or 2 ankylosed
teeth are more likely to have additional ankylosis later.
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| These
variances in statistics may be due to different ways of diagnosing
ankylosis, ethnic factors, or other reasons. (For example, a study
at the Pediatric Dentistry Clinic of the University of Minnesota's
School of Dentistry focused only on Caucasian children.) But the
studies all come to the same conclusion: while it may not be an
unusual condition, especially with lower first molars, ankylosis
is a serious condition. To ensure the healthy development of your
child's teeth, ankylosis must be addressed. |
Signs and sounds of ankylosis
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The
ankylosed tooth appears submerged because its roots don't grow at
same rate as other teeth.
The opposing tooth visibly loses alignment as it grows out of its
socket.
The permanent tooth is blocked out of position because the primary
tooth's roots failed to dissolve normally. |
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| Sooner
or later we may recommend removing the ankylosed tooth, to ensure
that your child's permanent teeth can develop straight and strong.
We also may recommend surgery to expose, protect, or reposition
the emerging tooth.. |
| Special,
sophisticated instruments can be used to identify ankylosis. But
one of the most reliable instruments is our ears! Simply by tapping
on the teeth, we can hear a distinct difference between an ankylosed
tooth and a normally growing tooth. That's why we may use the clean
handle of a dental mirror to tap lightly on children's teeth as
part of their regular dental exam. (An ankylosed tooth has a higher
pitched or dulled sound as opposed to the more cushioned sound of
a normal tooth.) |
| We
may recommend several solutions for ankylosis, depending on the
specific tooth and your child's situation. For example, with younger
children, we may simply recommend monitoring the situation for a
period of time, to watch how the primary and permanent teeth develop.
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| Often
we can diagnose ankylosis simply through observation. For example,
a tooth noticeably lower in growth is a tell-tale sign of ankylosis.
Also, with x-rays taken at regular checkups, we can view the development
of permanent teeth that may be blocked by the primary teeth's roots.
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| If
we must remove a primary tooth before the permanent tooth is ready
to emerge, we may use space maintainers to ensure that surrounding
teeth do not crowd out the emerging permanent tooth. Sometimes orthodontic
steps may be taken to ensure that your child's teeth align and the
bite is correct. In general, the sooner we can deal with your child's
ankylosed tooth, the fewer problems that are likely to develop later.
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