Prevalence and characteristics of and risk factors for impacted teeth with ankylosis and replacement resorption - a retrospective, 3D-radiographic assessment.

Background: Large variation in the prevalence of ankylosis and replacement resorption (ARR) is reported in the literature and most studies have relatively small patient numbers. The present retrospective study aimed to provide an overview on prevalence, location of, and associated risk factors with ARR based on a large sample of computed tomography (CT) / cone beam computed tomography (CBCT) scans of impacted teeth. The results should allow clinicians to better estimate the risk of ARR at impacted teeth.

Methods: The CT/CBCT scans of 5764 patients of a single center in Central Europe were screened with predefined eligibility criteria. The following parameters were recorded for the finally included population: gender, age, tooth type/position, number of impacted teeth per patient, and presence/absence of ARR. For teeth with ARR the tooth location in reference to the dental arch, tooth angulation, and part of the tooth affected by ARR were additionally registered.

Results: Altogether, 4142 patients with 7170 impacted teeth were included. ARR was diagnosed at 187 impacted teeth (2.6%) of 157 patients (3.7%); 58% of these patients were female and the number of teeth with ARR per patient ranged from 1 to 10. Depending on the tooth type the prevalence ranged from 0 (upper first premolars, lower central and lateral incisors) to 41.2% (upper first molars). ARR was detected at the crown (57.2%), root (32.1%), or at both (10.7%). After correcting for confounders, the odds for ARR significantly increased with higher age; further, incisors and first/second molars had the highest odds for ARR, while wisdom teeth had the lowest. More specifically, for 20-year-old patients the risk for ARR at impacted incisors and first/second molars ranged from 7.7 to 10.8%, but it approximately tripled to 27.3-35.5% for 40-year-old patients. In addition, female patients had significantly less often ARR at the root, while with increasing age the root was significantly more often affected by ARR than the crown.

Conclusion: ARR at impacted teeth is indeed a rare event, i.e., only 2.6% of 7170 impacted teeth were ankylosed with signs of replacement resorption. On the patient level, higher age significantly increased the odds for ARR and on the tooth level, incisors and first/second molars had the highest odds for ARR, while wisdom teeth had the lowest.