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Replacement resorption rate is a variable process, and is dependent on age, basal metabolic rate, extra-alveolar time, treatment prior to replantation, amount of root dentin, severity of trauma, and extent of periodontal ligament necrosis. In patients 7–16 years old a tooth is lost 3–7 years after the onset of root resorption. The complications that may develop as a consequence of ankylosis of a permanent incisor in children are due to the inevitable early loss of the traumatized tooth and local arrest of alveolar bone development. An ankylosed tooth should be removed before the changes become so pronounced that they compromise future prosthetic treatment. The treatment options may involve: interceptive regenerative treatment, early extraction of the ankylosed tooth, orthodontic space closure, intentional replantation, extraction of the ankylosed tooth followed with immediate ridge augmentation/preservation, auto-transplantation, single tooth dento-osseous osteotomy, and decoronation. The purpose of this article was to review the considerations involved in the decision-making concerning the use of the decoronation technique for the treatment of a permanent incisor diagnosed as ankylosed.