Dental Ankylosis: What It Is, Causes, Symptoms, and Treatment Options

Dental ankylosis is a condition in which the tooth becomes directly fused to the alveolar bone, losing the periodontal ligament that normally keeps it suspended and slightly mobile.

This fusion prevents the tooth from accompanying the normal growth of the jaws, leading to alterations in occlusion, aesthetics, and masticatory function.

Although it can affect both primary and permanent teeth, dental ankylosis is more common in children and adolescents, especially after dental trauma.

When not identified in time, it can compromise dental alignment, interfere with facial development, and complicate future orthodontic treatments.

At the office of Dr. Cláudio Alferes, specialist in orthodontics and occlusion, this condition is approached through a multidisciplinary method, with precise diagnosis and personalized planning to preserve both functional and aesthetic balance of the smile.

What Is Dental Ankylosis?

Dental ankylosis occurs when the tooth becomes “fused” to the alveolar bone, with no periodontal ligament present. This ligament is essential for cushioning masticatory forces and allowing the tooth to have slight physiological mobility.

Without it, the tooth becomes immobile and progressively lower in relation to adjacent teeth — a phenomenon known as infraocclusion.

In primary (deciduous) teeth, this process can delay or prevent the eruption of permanent teeth. In permanent teeth, ankylosis can cause occlusal imbalances, compromise chewing, and affect the aesthetics of the smile.

Causes of Dental Ankylosis

The causes of dental ankylosis are not fully understood, but it is known to involve a combination of traumatic, inflammatory, and genetic factors.

The most common causes include:

• Dental trauma, such as luxation or reimplantation after falls or accidents, which can damage the periodontal ligament.

• Local infections or inflammation, affecting the supporting tissues of the tooth.

• Developmental alterations, particularly in baby teeth, when root resorption occurs irregularly.

• Genetic predisposition, which can increase the risk of fusion between the tooth and the alveolar bone.

• Excessive masticatory pressure or inadequate orthodontic forces, which interfere with bone and periodontal metabolism.

Regardless of the cause, early detection is essential. A diagnosis made in the initial stages allows strategies to be implemented that prevent bone loss and future complications.

Symptoms and Diagnosis of Dental Ankylosis

Dental ankylosis may develop silently, often being identified during routine exams.

However, there are signs that should raise suspicion:

• A tooth that appears lower than the adjacent ones (infraocclusion).

• Lack of mobility of the tooth upon palpation.

• A metallic sound when the tooth is percussed with a dental instrument.

• Failure of eruption of a primary tooth even after the expected age.

• Progressive misalignment of neighboring teeth.

Diagnosis is made through detailed clinical examination and imaging studies, such as periapical or panoramic radiographs, or CBCT (cone-beam computed tomography).

These tools allow confirmation of the absence of the periodontal ligament and assessment of the extent of bone fusion

Treatment Options for Dental Ankylosis

Treatment depends on the patient’s age, the type of tooth affected, and the degree of ankylosis. The main goal is to preserve the alveolar bone and maintain functional occlusal balance.

Decoronation

Decoronation is a conservative technique indicated mainly for young patients, when an ankylosed tooth prevents normal bone growth.

The procedure involves removing only the crown of the tooth while preserving the root inside the bone.

Over time, the body naturally resorbs the remaining root, maintaining bone volume and allowing for future implant placement or other prosthetic rehabilitation.

This approach is particularly useful after dental trauma to anterior teeth, as it helps prevent vertical bone resorption and facilitates future aesthetic rehabilitation.

Other Approaches

Depending on the case, treatment may include:

• Extraction of the ankylosed tooth, followed by bone preservation and orthodontic or implant planning.

• Complementary orthodontic treatment to reposition adjacent teeth and restore proper occlusion.

• Prosthetic or implant rehabilitation in later stages, after bone stabilization.

Treatment planning must always be personalized, considering the patient’s age, occlusal type, and the need to preserve functional balance between teeth, muscles, and the temporomandibular joints (TMJ).

Importance of Specialized Follow-Up

Dental ankylosis requires accurate diagnosis and multidisciplinary planning, involving orthodontics, implantology, and restorative dentistry.

Inadequate clinical management can lead to premature bone loss, alteration of the facial profile, and the need for more complex treatments in the future.

At Dr. Cláudio Alferes’ office, each case is studied using advanced imaging technology and detailed functional analysis for every patient.

When to Seek Help for Dental Ankylosis

Although rare, dental ankylosis can have significant consequences for both function and aesthetics of the smile.

Recognizing the early signs and seeking specialized care are essential steps to ensure successful treatment and preserve occlusal harmony.

Do you suspect that you or your child may have an ankylosed tooth, or that a tooth eruption is delayed?

Schedule an evaluation with Dr. Cláudio Alferes and discover the most appropriate treatment plan for your case.