parents ask: 'Can we use braces to pull the tooth back…
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A 10-year-old had a closed-apex incisor replanted 2 years ago. The tooth is now confirmed ankylosed (metallic percussion, absent PDL space, beginning infra-position at 1.5mm). The orthodontist notes active facial growth. The parents ask about the full range of options and timing. The parents ask: 'Can we use braces to pull the tooth back into alignment?' What is the correct answer and why?
- A. Yes — modern orthodontic techniques can successfully move ankylosed teeth with increased force application over time
- B. No — ankylosed teeth are fused to bone and cannot be moved orthodontically; alternative approaches are needed
- C. Yes — but only after decoronation is performed first, which separates the tooth from the bone for movement
- D. No — but the tooth will naturally self-correct as the child grows, since facial growth tends to level the occlusal plane
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Integration: (1) Ankylosis = bone fusion = no PDL = impossible to move orthodontically. (2) Growth worsens infra-position (Sec 11.3). (3) Treatment options are non-orthodontic: decoronation, autotransplant, prosthetics (Sec 12). (4) Decoronation is NOT a prerequisite for movement — it's a separate procedure. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Sections 11.3.1, 12
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