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Tooth Ankylosis

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Description: Tooth ankylosis is a dental condition where a tooth becomes fused to the jawbone, usually resulting in impaired tooth eruption and occlusion.
Type: Tooth ankylosis is classified as a dental condition where a tooth becomes fused to the surrounding alveolar bone, preventing its normal movement. This condition is generally not considered to have a genetic basis or specific type of genetic transmission. Instead, it is more often associated with trauma, infection, or other localized factors affecting the tooth and surrounding tissues.
Signs And Symptoms: Tooth ankylosis can be recognised clinically by the loss of physiological mobility, and a high P note. It may also be detected radiographically, loss of periodontal ligament space and evidence of replacement resorption. Ankylosis usually initially occurs on the labial and lingual root surfaces making radiographic detection in the early stages difficult. Early diagnosis allows the practitioner to plan for future complications.

The signs and symptoms for patients can be varied mainly depending on the growing state of teeth (permanent or deciduous). Other factors, such as age, sex, site of infection may also lead to the occurrence of specific signs and symptoms, but their roles are not well-studied and evaluated. General symptoms include decreased tooth count, abnormal tooth enamel, curving of the fifth digit, enlarged lower jaw and abnormal dentition, with decreased tooth count as the most frequent symptom.For non-growing subjects who possess fully developed permanent teeth, there may not be any observable symptoms. The alveolar support of the affected tooth will be lowered due to continuous replacement resorption of the root. This process will stop with the appearance of root fractures and shed crown, and changes in dentition, especially the anterior teeth, can be observed in this stage. Symptoms such as infraocclusion and asymmetry in the smile arc may be developed. However, for ankylosis in posterior teeth happening in non-growing subjects, it may be completely asymptomatic because the slow change in height of the affected teeth may not be noticeable to both the patient and the doctor, compared to that happened in anterior teeth.For growing subjects, symptoms can also be varied as different growth aspects of teeth including the vertical, sagittal and transverse growth are different in children and adolescents. Generally, symptoms are more severe for earlier occurrence of the disease. Most ankyloses occurring in children are trauma-induced, which can lead to malposition of the affected teeth as the major symptom.For moderate and severe conditions in growing subjects, symptoms such as functional impairment due to loss of occlusal contacts which results from the reduced vertical distance of the ankylosed teeth, and shift in dental midline associated with tipping of adjacent teeth towards the affected tooth, are likely to be developed. Alternatively, open bite and supra-eruption of opposing teeth may also be noticed.
Prognosis: Tooth ankylosis has a generally unfavorable prognosis since it involves the fusion of the tooth to the bone, preventing normal movement and eruption. This condition can lead to complications, such as altered bite, misalignment of adjacent teeth, and potential damage to the jawbone structure. The extent of these issues often depends on the severity of the ankylosis and the specific tooth involved. Treatment options may include surgical intervention or extraction, but long-term management often necessitates orthodontic and restorative care to address resultant dental complications.
Onset: Tooth ankylosis can occur at any age but is most commonly observed in children and adolescents. The condition involves the abnormal fusion of a tooth's root to the surrounding alveolar bone, leading to issues in tooth eruption and alignment. The exact cause is not always clear, but it has been associated with trauma, infection, and genetic predisposition. Early detection and intervention are crucial to managing potential complications in dental development.
Prevalence: The prevalence of tooth ankylosis (a dental condition where a tooth becomes fused to the bone, preventing it from erupting or moving) varies widely. It is relatively uncommon in the general population but more frequently seen in children with primary teeth. Prevalence rates can range from 1.5% to 9.9% in primary teeth, whereas it is less common in permanent teeth.
Epidemiology: The prevalence of tooth ankylosis is still unknown. Individuals of both genders regardless of the ethnic groups may be affected due to inheritance or sporadic traumatic injuries.

== References ==
Intractability: Tooth ankylosis, a condition where the tooth root fuses with the surrounding bone, can be challenging to manage but is not necessarily intractable. Treatment options, such as surgical intervention or orthodontic techniques, can address the issue, though the complexity and success may vary on a case-by-case basis.
Disease Severity: Tooth ankylosis is a dental condition where the tooth root fuses with the surrounding alveolar bone, leading to a lack of normal tooth mobility. This can interfere with tooth eruption and alignment. The severity of tooth ankylosis varies; in mild cases, it may have minimal impact, while in more severe cases, it can cause misalignment of the dentition and may require dental intervention.
Healthcare Professionals: Disease Ontology ID - DOID:12661
Pathophysiology: Ankylosis initiates with extensive necrosis of the periodontal ligament with formation of bone which will invade the denuded root surface area. Trauma is believed to be the cause of ankylosis, causing cell death on the root surface. Ankylosis may happen once the injured surface area has reached more than 20%. Damage to the root surface area will trigger an inflammatory response, migration and repopulation of faster bone forming cells, instead of slower periodontal ligament fibroblasts or cementoblasts, occurring in the teeth root surface. In this stage, the teeth are termed to be ankylosed. This migration and repopulation process, termed replacement resorption, will continue and thus the teeth root will become fused with the bone tissue adjacent to it.
Carrier Status: Tooth ankylosis is not typically associated with a carrier status because it is not a genetic disease in the traditional sense. It is a dental condition where a tooth becomes fused to the jawbone, preventing it from properly erupting or aligning with other teeth. The exact cause is often unknown but may involve trauma, infection, or developmental disturbances.
Mechanism: Tooth ankylosis is a dental condition where a tooth becomes fused to the surrounding bone, preventing it from moving or erupting properly. Here is a concise overview:

**Mechanism:**
1. **Fusion of Tooth to Bone:** In tooth ankylosis, the periodontal ligament, which normally cushions the tooth and allows for movement, is absent or destroyed.
2. **Bone Remodeling:** Osteoblasts deposit bone directly onto the tooth root, creating a direct connection (ankylosis) between the tooth and the alveolar bone.
3. **Loss of Normal Function:** This fusion inhibits normal tooth function and movement, including eruption, leading to issues with alignment and occlusion.

**Molecular Mechanisms:**
1. **Cytokine Activity:** Inflammatory cytokines, such as interleukins (e.g., IL-1, IL-6) and tumor necrosis factor-alpha (TNF-α), can promote the resorption of the periodontal ligament and facilitate bone deposition.
2. **Osteoprotegerin (OPG) and RANKL/RANK Pathway:** Disruption in the balance between OPG and the RANKL/RANK pathway can result in increased bone remodeling and the direct apposition of bone onto the tooth root.
3. **Genetic Factors:** Mutations or polymorphisms in genes related to bone metabolism (e.g., BMPs, RUNX2) may contribute to an increased susceptibility to ankylosis by altering the normal bone and periodontal ligament homeostasis.
4. **Matrix Metalloproteinases (MMPs):** Elevated levels of MMPs, which degrade extracellular matrix components, can facilitate the destruction of the periodontal ligament, allowing for bone-tooth fusion.

Understanding these mechanisms provides insight into the complex interplay of cellular and molecular factors that lead to tooth ankylosis, and helps identify potential therapeutic targets to treat or prevent this condition.
Treatment: Growing state of patient is one of the factors when deciding what treatment is going to be used.
For growing patients, decoronation is used. Decoronation is the removal of tooth crown. It serves as an alternative surgery for tooth extraction. It is recommended over extraction because it limits bone resorption and therefore maintains a sufficient growth of alveolar bone to enable tooth implantation. Decoronation can be carried out on both deciduous and permanent teeth. However, if the patient is too young and not close to puberty, decoronation should be postponed. In order to maximize the benefits of decoronation, regular monitoring and intervention are needed.For non-growing patients, decoronation is generally not recommended because the growth of alveolar bone may be inadequate for a future tooth implant, and therefore is said to not give ideal treatment outcomes. As a result, other methods are considered when treating non-growing patients.
Follow-ups are often being adopted in the cases of late onset tooth ankylosis. As tooth growth is insignificant, no surgical procedures are needed to treat the ankylosed tooth as long as its height difference with adjacent teeth is small. In some cases where the height difference is more significant, tooth crown build-up is recommended to restore occlusion.In addition to tooth crown build-up, ankylosed teeth repositioning is another conservative method. In surgical luxation, after the bridge of ankylosis is broken mechanically, the tooth is positioned slightly away from its original site and allowed to erupt with a temporary insertion of a splint or an orthodontic appliance. Tooth repositioning can also be performed by osteotomy and distraction osteogenesis in cases where surgical luxation fails, or as alternatives.Extraction of an ankylosed tooth can be considered in both growing and non-growing patients. This method usually serves as a last resort when other methods such as osteotomy and distraction osteogenesis fail to treat ankylosis.Growing state of patient is not the sole factor when deciding the treatment for an ankylosed tooth. Infraocclusion severity, bone resorption, location of the target tooth as well as dentist's preference all affect the option for treatment. Therefore, treatment for an ankylosed tooth is case-specific.
Compassionate Use Treatment: Tooth ankylosis is a dental condition where a tooth becomes fused to the surrounding bone, preventing it from moving. There are currently no specific compassionate use treatments designated for tooth ankylosis. However, off-label or experimental treatments may include:

1. **Surgical Intervention**: This might involve the extraction of the ankylosed tooth or surgical separation of the tooth from the bone followed by repositioning.

2. **Autogenous Transplantation**: This involves transplanting the affected tooth after treatment to an appropriate location in the mouth, though this is highly experimental and not widely practiced.

3. **Distraction Osteogenesis**: Considered experimental, this technique involves the gradual movement of the teeth and bones to correct ankylosis.

4. **Bone Grafting**: This off-label method involves grafting new bone around the ankylosed tooth to promote new bone formation, potentially allowing for normal tooth movement.

5. **Orthodontic Devices**: Some experimental approaches use specialized orthodontic devices that attempt to move the anchoring bone surrounding the ankylosed tooth.

These treatments are primarily in the experimental stage and should be discussed thoroughly with a dental specialist to understand risks and benefits.
Lifestyle Recommendations: Tooth ankylosis is a condition where the tooth becomes fused to the bone, preventing it from moving or erupting normally. Here are some lifestyle recommendations for managing this condition:

1. **Oral Hygiene**: Maintain excellent oral hygiene to prevent further complications. Brush and floss regularly.
2. **Regular Dental Visits**: Schedule regular check-ups with your dentist to monitor the condition and receive professional cleanings and interventions as needed.
3. **Balanced Diet**: Eat a balanced diet rich in vitamins and minerals to support overall dental health.
4. **Avoid Hard Foods**: Be cautious with hard foods that might cause additional stress on the ankylosed tooth or surrounding teeth.
5. **Jaw Exercises**: Depending on advice from your dentist or orthodontist, certain jaw exercises might help in maintaining mobility and function of the jaw.

Consult a dental professional to devise a personalized management plan.
Medication: Tooth ankylosis does not have a specific medication for treatment. Managing the condition typically involves dental procedures rather than pharmacological intervention. If there is discomfort, over-the-counter pain relievers like ibuprofen or acetaminophen may be recommended, but these do not treat the ankylosis itself. Consult a dentist for appropriate management options, which may include monitoring the condition, orthodontic treatment, or in severe cases, extracting the affected tooth.
Repurposable Drugs: Tooth ankylosis is a condition where the tooth becomes fused to the surrounding bone, preventing it from properly erupting or moving. Currently, there are no well-established repurposable drugs specifically for the treatment of tooth ankylosis. Standard treatments are typically focused on surgical intervention or orthodontic management to address the condition.
Metabolites: Tooth ankylosis primarily affects the dental tissue rather than metabolic processes, and there is limited specific information available about metabolites directly associated with this condition. Tooth ankylosis occurs when the root of a tooth fuses to the surrounding alveolar bone, preventing the tooth from erupting or moving properly. This fusion leads to the absence of periodontal ligament space and can often be identified through dental X-rays or CT scans. Since metabolite information specific to tooth ankylosis isn't well-documented, general dental health and bone metabolism factors may indirectly play a role.
Nutraceuticals: Tooth ankylosis is a dental condition where the tooth fuses to the jawbone, impairing normal eruption and alignment. Currently, specific nutraceuticals to treat tooth ankylosis are not well-established in the literature. Management often involves dental intervention to correct or compensate for the ankylosed tooth. Research in nanotechnology for dental applications is ongoing, but explicit nanotechnological treatments for tooth ankylosis remain experimental and are not widely available as standard care.
Peptides: Tooth ankylosis is a dental condition where a tooth becomes fused to the surrounding bone, preventing it from erupting properly or moving within the jaw. This fusion occurs because the periodontal ligament, which normally separates the tooth from the bone, is lost.

1. **Peptides**: There is currently limited evidence specifically involving peptides in the treatment or management of tooth ankylosis. However, research in regenerative medicine and tissue engineering is ongoing, and peptides may potentially play a role in future therapies aimed at modifying bone or periodontal ligament growth.

2. **Nanotechnology**: Nanotechnology is an emerging field that could have potential applications in the diagnosis and treatment of tooth ankylosis. For instance, nanoparticles could be used to deliver drugs or growth factors more effectively to the affected area, promoting tissue regeneration or preventing further fusion of the tooth to the bone. However, such applications are still largely in the experimental stages and not yet part of routine clinical practice.