Ankylosis remains one of the major complications associated with impacted teeth in children. Orthodontically-assisted eruption of an ankylosed tooth may intrude or displace the adjacent teeth. Children who undergo orthodontically assisted eruption should be followed closely to ensure that movement of an impacted tooth is occurring. In general, the removal or assisted eruption of impacted teeth in children requires a thoughtful interdisciplinary evaluation between the surgeon and orthodontist/primary dental care provider. Factors that must be considered include operative feasibility, orthodontic management, future growth, and psychosocial considerations. The use of emerging technology, such as cone beam CT and skeletal anchorage, should better equip surgeons to navigate the anatomy three-dimensionally and provide assistance in management of difficult cases.