Management of intrusive luxation injuries

Abstract

Traumatic intrusion of permanent teeth is a relatively infrequent but serious type of dental injury, due to the complicated picture it involves. Various treatment approaches have been suggested, so far, regarding management of intrusive luxation. Techniques aiming to reposition the intruded tooth include observation for spontaneous reeruption, surgical as well as orthodontic repositioning. However, development of complications such as pulp necrosis, inflammatory root resorption, replacement resorption and ankylosis and loss of marginal bone support makes selection of the most favorable technique controversial. In this paper, a critical review of the existing treatment modalities is attempted and treatment approaches based on diagnostic parameters that are indicative of the severity of an intrusive injury are presented. Recommendations are made after taking into consideration experimental and clinical study findings and observations from other author's and our own clinical experience. Two cases of intrusive luxation in children are presented and management of the dental injuries as well as the complications which occurred are being discussed.

Reposition of intruded permanent incisor by a combination of surgical and orthodontic approach: a case report

“…[1][2][3][4] Common sequelae to the traumatic intrusion are ankylosis (replacement resorption), external root resorption, pulpal necrosis, inflammatory resorption. 1,5 Historically, suggested treatment methods of intruded teeth have been spontaneous re-eruption, immediate surgical repositioning and fixation, orthodontic repositioning, and a combination surgical and orthodontic therapy.…”

“…[1][2][3][4] Common sequelae to the traumatic intrusion are ankylosis (replacement resorption), external root resorption, pulpal necrosis, inflammatory resorption. 1,5 Historically, suggested treatment methods of intruded teeth have been spontaneous re-eruption, immediate surgical repositioning and fixation, orthodontic repositioning, and a combination surgical and orthodontic therapy. 5 Andreasen 3,4 and Hollan 6 reported that spontaneous re-eruption was common in the primary dentition and the spontaneous re-eruption of permanent teeth occurred mostly in immature teeth and rarely in teeth with closed apices.…”

Conservative management of progressive external inflammatory root resorption after traumatic tooth intrusion

“…recommended that each case should be considered individually and the treatment should take into account the severity of the intrusion and tooth mobility. [13]…”

Endodontic and Orthodontic Management of Traumatically Intruded Teeth with Horizontal Root Fracture: A Case Report

“…So, in the present case, due to the characteristic of severe intrusion (more than 6 mm) and pulpal necrosis, the most indicated procedure was the multidisciplinary endodontic and orthodontic management. Orthodontic repositioning represent a more biological procedure for teeth who suffered this kind of injury [15] moreover, an emergency endodontic treatment prevents inflammatory root resorption [13, 15–17]. …”