Decoronation as a Ridge-Preserving Strategy for Ankylosed Permanent Teeth: An Overview of Scientific Reports in Dentistry through the Years
Carlos Roberto Emerenciano Bueno *
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Ana Laura Ribeiro Ruiz
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Gabriele Oliveira Amaral
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Ana Laura Alves da Costa
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Patrícia Venturini Florencio
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Ana Maria Veiga Vasques
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Luciano Tavares Angelo Cintra
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Gustavo Sivieri-Araújo
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Rogério de Castilho Jacinto
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
João Eduardo Gomes-Filho
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
Eloi Dezan Júnior
Department of Restorative Dentistry and Endodontics, Araçatuba School of Dentistry, Sao Paulo State University (FOA/UNESP), São Paulo, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Decoronation is a conservative surgical technique in which the crown of an ankylosed permanent tooth is removed below the level of the cementoenamel junction whilst the root is retained in situ within the alveolar socket. First described in 1984, the procedure was developed as a biologically rational response to the clinical challenge posed by replacement resorption and dentoalveolar ankylosis in growing patients. In the decades following its introduction, decoronation attracted considerable clinical interest, and a growing body of scientific literature has examined its outcomes with increasing rigour. This critical narrative review synthesises the scientific literature on decoronation published between 2000 and 2025, supplemented by the foundational 1984 report, to provide a comprehensive account of the procedure's historical development, biological underpinnings, surgical technique, clinical evidence, evolving indications, post-operative management, and long-term prosthetic sequelae. The literature search was conducted during the period from January 2000 to April 2025. Evidence from systematic reviews, retrospective cohort studies, case series, and case reports consistently demonstrates that decoronation preserves both the buccolingual width and the vertical height of the alveolar ridge in growing individuals, enabling future implant-based rehabilitation under significantly more favourable anatomical conditions than those achievable after conventional extraction. Recent advances, including flapless approaches and expanded application to non-traumatic conditions such as external cervical resorption, have widened the clinical scope of the procedure. The cumulative evidence supports decoronation as the preferred intervention for ankylosed permanent incisors in children and adolescents when performed at the appropriate developmental stage, although the evidence base remains largely observational and heterogeneous in design. Future research should prioritise prospective comparative studies, standardised outcome measures, and refined criteria for timing.
Keywords: Decoronation, dentoalveolar ankylosis, replacement resorption, alveolar ridge preservation, dental trauma, implant rehabilitation, ankylosed incisor, growing patient