Delayed orthodontic extrusion of a traumatically intruded immature upper permanent incisor – a case report

Abstract

Dental injuries are probably the most common orofacial injuries sustained during sports and play. Intrusion or intrusive luxations occur when the teeth are driven into the alveolus by an axially directed impact. This article describes the clinical case of an 8-year-old patient who suffered complete intrusive luxation of an immature permanent central incisor following an accident. An attempt at spontaneous re-eruption failed to facilitate re-emergence of the tooth beyond 2 mm. The recommended wait-and-see strategy in anticipation of spontaneous re-eruption should cease to be an option when no further elongation can be observed. Orthodontic extrusion or surgical re-positioning is a valid treatment alternative when the former fails. In this case, although the recommended time period for effecting orthodontic extrusion had elapsed, this procedure was undertaken successfully presumably owing to the application of controlled, biologically optimal forces. A review of the extruded tooth a year later revealed no clinical or radiographic signs of loss of vitality. This was confirmed radiographically by the completion of root development, an intact lamina dura and no evident signs of resorption.

Different outcomes of managing severe intruded immature permanent incisors: A report of two cases

“…Umesan et al applied an almost comparable procedure and obtained tooth orthodontic replacement 7 months after injury. 9 It can be assumed that orthodontic repositioning in the aforementioned report progressed more rapidly than in our case due to an earlier stage of root development. However, the authors did not carry out root canal treatment because the pulp responded to the vitality test, while post-treatment review 1 year later revealed that the entire pulp canal appeared partially obliterated.…”

“…It has been shown that immature teeth present a better prognosis than do those with complete root formation. 3,6,9,14 Despite the implementation of an identical procedure in case report 2, eruption under traction proceeded unsatisfactorily and radiological examination revealed ankylosis. Therefore, a corticotomy and luxation were administered as supportive treatment to hasten re-eruption.…”

“…The main etiological factors include bicycle accidents, sports, recreational activities, or falls. 4,5,9 A longitudinal clinical and radiographic evaluation of intruded teeth in a pediatric population, undertaken by Siebra Moreira Neto et al, demonstrated that tooth intrusion was twice as frequent in males and the maxillary central incisors were the most commonly affected teeth (93.3%), which is related to their anatomic position in the dental arch. 10 The cases reported here also confirmed these findings.…”

Intrusive luxation in primary dentition: clinical report

“…Por otro lado, Moura et al (2011) y Altun, Esenlik y Tozum (2009) no observaron diferencias entre géneros 18,16 . Entre las causas más frecuentes se encuentran las caídas, accidentes y colisiones 19 , siendo los dientes anteromaxilares los más afectados 20,21 . Las características conductuales y la presencia de maloclusión también se encuentran entre los factores predisponentes para los episodios traumáticos 22 .…”

Multidisciplinary treatment for a patient with traumatically intruded permanent canine and premolar

“…In most previous case reports, orthodontic extrusion of traumatically intruded teeth was performed according to the sectional archwire technique. 15,16 In the present case, a lingual arch appliance was used to prevent side effects taking into consideration the ankylosis. In addition, the premolar rest was attached to the lingual arch appliance, as the patient exhibited a deep bite, in order to prevent further intrusion of the upper molar, which would have made the overbite deeper (Fig.…”