A Retrospective Case Series of Decoronation and Root Submergence With Long-Term Follow-Up: Trend Analysis of Provisional Restoration Survival and Marginal Bone Development.

Abstract

Background: Dentoalveolar ankylosis posttrauma or external cervical resorption (ECR) post orthodontics might affect permanent teeth in growing individuals. Decoronation and root submergence attempt to minimize the impact of these sequelae. This is one of the few reports in which the survival of provisional restorations and preservation of the marginal bone post long-term follow-up of this treatment modality were evaluated for several cases.

Materials and methods: Nine upper permanent incisors with ankylosis or ECR, treated using decoronation and root submergence were examined. The qualitative changes in the vertical dimension of the alveolar ridge were measured on periapical radiographs by means of a three-point scoring system, and the time to moderate and considerable bone increase was assessed using Kaplan-Meier curves. The quantitative changes in vertical bone dimension were measured on the periapical radiographs and the inter-rater reliability was assessed. The survival of the temporary restoration post decoronation and the presence of root remnants were evaluated. The mean age of the patients was 11 years at the time of trauma and 15.3 years when decoronated. The follow-up period post decoronation was 1.5-8.5 years (mean 3.5 years). Post decoronation, quantitatively, 5 cases presented a slight bone increase (0.01-2 mm) and 4 unchanged or slightly decreased bone levels (0.2-1.3 mm). Qualitatively, 60% (95% CI; 15%-90%) of the female patients showed moderate bone increase and 40% (95% CI; 10%-70%) considerable, respectively, 1.7-8.3 and 2.5-8.3 years post decoronation. Age was inversely proportional with bone increase, independent of gender. At 1.5 years follow-up, root remnants were present in all cases. The tooth shaped as a pontic failed the most as a temporary restoration.

Conclusion: Despite limitations, the following can be concluded: decoronation and root submergence of permanent incisors in growing individuals seem promising in terms of long-term vertical alveolar ridge preservation. The restorative temporary replacement of decoronized teeth is challenging.