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Topics of the day:

1. Forced eruption

Dear Colleagues,

I have a patient who has a hopeless #9, and the case was referred to me for slow extrusion of #9 prior to implant placement to augment the hard and soft tissues.  I have done a number of these cases and have never had a problem.  With this particular patient, using my normal mechanics (step downs on a round wire), tooth #9 is not moving at all.  Rather, #10 is intruding.  My first thought was that #9 is ankylosed (this tooth has undergone trauma, as well as periodontal surgery in which MTA was used near a fracture line on the root).  However, the tooth is still clincially mobile.  Could this be a "spot" ankylosis?  The periodontist involved in the case has recommended luxation of the tooth and then re-trying the orthodontic extrusion.  Does anyone out there have any ideas or suggestions? Thank you for your replies,

Sincerely,
Alexander Waldman