[Diagnosis and management of ankylosed permanent maxillary incisors: proposal for a decision tree]

Ankylosis of a maxillary incisor involves evolutive resorption for which clinical management is difficult for both general practitioners and orthodontists. This anomaly can give rise to potentially major aesthetic, functional and occlusal defects. The ankylosed tooth will be lost, in the short or long term, depending on the bone remodeling.

The aim of this review was to determine the different therapeutic options known to date and allow the construction of several clinical decision support systems (summary tables and decision tree).

The different techniques were classified in three categories: abstention, conservative treatments and surgical treatments. The therapeutic objectives, indications and potential complications were listed for each technique. The possible persistence of an ankylotic zone or the ability to move the tooth after treatment was also recorded.

The therapeutic solution is decided on after a precise diagnosis in order to evaluate the extent of the resorption and its localization. The chosen treatment will be more or less stable, conservative, aesthetic and expensive, and will have varying success rates. The time component must be taken into account and an individualised diagnosis and treatment plan are necessary to select the most appropriate therapeutic option for patients.