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(c) Intraoral photograph during decoronation as the full-thickness flap is raised around the ankylosed tooth. (d) Intraoral photograph during decoronation, as the pulp tissue is removed from the root canal using an endodontic K-file.
Considering the severity of the clinical findings it was decided to try in the first instance subluxation and immobilization of the ankylosed tooth. This decision was based on the facts that the affected tooth presented with a favourable eruption axis, the root development was incomplete, there was adequate space to erupt into occlusion and the maxillary first molar had not over-erupted.
Radiographically, a step in the occlusal plane is observed and there may be an angular defect of the alveolar bone angled towards the ankylosed tooth [Brearley and McKibben, 1973; Kokich and Kokich, 2006].