A retrospective analysis of the optimal time and psychological impact of decoronation in children and adolescents

Background/aims: Decoronation offers one of the best and most predictable clinical outcomes for dentoalveolar ankylosis. The aim of this study was to determine the factors associated with the efficacy and psychological impact of decoronation for bone preservation.

Materials and methods: The study included 42 paediatric patients with 42 infrapositioned replanted permanent teeth. Twelve of these teeth were decoronated. Variables such as the time of injury, stage of root development and the extent of infraposition were analysed. The vertical changes in the alveolar bone level of the decoronated teeth were assessed on radiographs using a three-point scoring system. Parents of 30 patients with teeth that were not decoronated completed a questionnaire addressing their considerations and concerns regarding the treatment of infraposition.

Results: Teeth with root development in stages 2 and 3 showed a significantly higher rate of severe infraposition during the follow-up visits. Decoronation was performed on 12 teeth within 1.5-5 years (mean 3.8 ± 1.3 years) after replantation and 11 of these cases developed a considerable alveolar bone level. The alveolar bone levels of boys and girls showed improvements of 2.2 and 3.2 mm, respectively. The optimal age for decoronation to have a considerable increase in bone level was 12.12 ± 0.83 years for boys and 11.25 ± 1.77 years for girls. Complicated treatments, followed by parents' lack knowledge regarding decoronation, children's fear, follow-up times, and cost were the major concerns regarding decoronation.

Conclusion: The optimal time for decoronation should be decided after considering the age, gender, skeletal growth pattern, and the degree of infraposition at the time of decoronation.