top of page

Surgical Removal of Ankylosed #11

Surgical Procedure

Chief Complaint

Persistent discomfort in upper right central incisor (#11) following previous avulsion and reimplantation.

Clinical Findings

Tooth #11:

  • History of avulsion → reimplantation

  • Prior root-fill with thin root walls; possible internal resorption

  • Intruded and discoloured

  • Patient reports itching and discomfort (partially improved after Vit E and reduced brushing trauma)

  • Discomfort persists especially late afternoon and at night

  • Clinical findings:

    • Very slight TTP, NTTPp

    • No mobility

    • Deep labial probing depth due to previous intrusion

    • Metallic sound on percussion → ankylosis suspected

    • Very dense surrounding bone

    • Extremely thin buccal and palatal bone

    • Large palatal void due to palatine canal anatomy

  • CBCT confirmed ankylosis and unfavourable anatomy

Diagnosis: Ankylosed, non-restorable #11 with persistent symptoms.

Treatment Plan

  • LA oral surgery for removal of ankylosed #11

  • Curettage and socket debridement

Delayed immediate implant placement recommended (~2 weeks post-extraction)

Pre-operative Assessment

  • CBCT reviewed with patient

  • Risks and challenges discussed, including:
    • Difficult elevation due to ankylosis
    • Risk of buccal/palatal plate loss
    • Need for sectioning

  • Patient understood and agreed

Informed consent obtained for LA OP removal of #11

Anesthesia

Local infiltration.

Surgical Procedure

  • Patient cleaned and draped

  • Incision made; buccal flap raised

  • Minimally invasive approach

  • No bone guttering required

  • Extensive tooth sectioning performed

  • Periotomes used to break ankylotic fusion to bone

  • #11 elevated in 4 pieces

  • Curettage and saline irrigation

  • BSS × 2 placed for secondary closure

Hemostasis achieved; POI given

Post-operative Assessment

  • CBCT reviewed with patient

  • Risks and challenges discussed, including:
    • Difficult elevation due to ankylosis
    • Risk of buccal/palatal plate loss
    • Need for sectioning

  • Patient understood and agreed

  • Informed consent obtained for LA OP removal of #11

bottom of page