Minimum Surgico-Orthopedic Treatment using Computer-Assisted Single-Tooth Osteotomy in an Adolescent Skeletal Class III Patient with Anterior Ankylosed Tooth: A Case Report

Traumatic tooth avulsion can lead to ankylosis, which may interfere with growth of the alveolar bone in a growing patient. The resulting difference in alveolar bone height and position can lead to esthetic problems such as open bite. A growing 13-year-old female patient presented skeletal Class III malocclusion with bone ankylosis of a maxillary anterior tooth. Even after 2 years of orthopedic and orthodontic treatment, little improvement was achieved regarding the positions of the anterior maxillary teeth, or the vertical position of the maxillary right central incisor. Therefore, surgical treatment by single-tooth osteotomy (STO) and corticotomy for the anterior ankylosed tooth were considered and performed using a CAD/CAM surgical guide, based on presurgical computer-based simulation surgery. Orthodontic and orthopedic treatments were completed at 10 months after surgery. The patient showed a favorable course of healing, with no mobility issues or gingival recession 3 years after single-tooth osteotomy and corticotomy surgeries. A favorable outcome was finally achieved by applying orthopedic treatment combined with STO and corticotomy for the anterior ankylosed tooth. Orthodontic treatment with minimally surgical method is recommended in an adolescent patient with skeletal Class III malocclusion and anterior open bite.