Ankylosis may occur after traumatic dental injuries and especially after luxation-type injuries. Ankylosis may progress slowly or fast but will eventually lead to loss of the tooth. In growing individuals, ankylosis leads to infraposition of the affected tooth. For the same reason, implant treatment is not recommended before alveolar growth has terminated to avoid implant infraposition. In selected cases, orthodontic space closure or autotransplantation of a premolar may be the ideal permanent tooth replacement when ankylotic teeth are lost in childhood or early adolescence. In other cases, different interceptive treatment options exist to limit the dimensional changes of the alveolar ridge and to preserve hard and soft tissue in the case of ankylosis. These include decoronation, sandwich osteotomy and ridge preservation. This article discusses characteristics of clinical scenarios suitable for each treatment alternative, and presents a decision tree that can be applied when ankylosis is identified.