Wednesday, May 4, 2016
Healthy Mouth, Healthy Kids
Diagnosis of Ankylosed Tooth
Is it possible to diagnose a tooth as ankylosed simply by looking at an x-ray? A 6-year molar in my 14 year old`s mouth has not erupted - 2 years ago a cyst above that tooth was removed by an oral surgeon. One orthodontist wants to extract the tooth, claiming it is ankylosed simply by looking at an x-ray. Another orthodontist states that the molar is impacted and would like to have the tooth bonded and attempt to pull it up - the second orthodontist believes that if the molar then does not move, it is ankylosed. So can an ankylosed tooth be diagnosed by looking at an x-ray?
Ankylosis can be diagnosed typically when one tooth appears 'submerged' in relation to the neighboring teeth on an xray. Practitioners will also use percussion (ankylosed teeth make a characteristic metallic sound), but these are subjective. Remember that an xray is a two-dimensional image of a three-dimensional object. In some cases, there is simply a single point of ankylosis along the entire root surface, and in some cases pressure on the tooth can cause movement. It is also possible that the cyst somehow impacted the tooth development.
You might want to consult with an oral and maxillofacial surgeon who might use some additional imaging to make a diagnosis. I hope this helps.
Sarath Thikkurissy, DDS, MS
Director, Residency Program, Division of Pediatric Dentistry and Orthodontics
College of Medicine
University of Cincinnati