Management of Ankylosed Teeth with Fixed Space Regainer: Case Reports

Ankylosis, the abnormal fusion of root cementum and surrounding bone, commonly affects primary molars, leading to space loss and infraocclusion. This often results in mesial tipping of the adjacent permanent molar, necessitating orthodontic intervention to regain space, upright the molar, and establish proper occlusion. In mixed dentitions, patient compliance and proper appliance design are critical, as inappropriate appliances can cause root resorption and undesirable tooth movements. This case report presents a three-step treatment approach for managing ankylosis using a novel fixed appliance that uses the ankylosed tooth as skeletal anchorage. The process includes 1) space regaining, 2) extraction of the ankylosed tooth, and 3) space maintenance for the successor tooth’s eruption. The fixed appliance, comprising a minitube, double-helical spring, free arm, and resin ball, was used to regain space and facilitate the eruption of the permanent successor by correcting the inclination of the adjacent first permanent molar. Two patients with mixed dentitions were treated successfully, achieving space regaining and molar uprighting without anchorage loss. This three-step treatment is simple, effective, and produces desirable outcomes in a short time, making it a promising alternative for pediatric patients with ankylosis, space loss, and mesial inclination of adjacent teeth. The novel appliance emphasizes the importance of stable and biocompatible anchorage in pediatric dentistry.