Traumatic intrusion of permanent teeth: 10 years follow‐up of 2 cases

Abstract

Intrusive luxation is a kind of traumatic injury characterized by an axial displacement of the tooth toward the alveolar bone. Its main causes are bicycle accidents, sports/recreational activities, and falls or collisions. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. In order to decide which treatment to follow, the degree of root formation, the patient's age, and intrusion severity should be taken into consideration. This study aimed to report a 10-year follow-up of two patients that suffered permanent incisor (PI) traumatic injury who had a similar root development (incomplete rooting) but different results. In the first case, the treatment of choice was follow-up. The patient showed gingival alteration and root resorption of tooth 21. Calcium hydroxide therapy and root canal filling were performed twice because of not attending callback. After finishing the endodontic treatment, follow-up visits showed no abnormalities. In the second case, the treatment of choice was watch and wait to the teeth 11 and 21. After 7 months spontaneous eruption of both teeth was detected. Radiographic examination showed atypical root formation and almost completely pulp canal obliteration, 8 years later. In the follow-up, visit after 10 years was observed complete crow and pulp canal obliteration. It was concluded that PI intrusion treatments are good intervention alternatives, as they proved to be successful after a 10-year follow-up period.

Mineral Trioxide Aggregate for Intruded Teeth with Incomplete Apex Formation

“…For this reason, apexification with calcium hydroxide for extended periods of time may lead to possible root fracture 2) . The period of treatment of immature permanent teeth depends on a number of factors, such as the size of the apical opening, the direction of the traumatic displacement of the tooth (strict axial, axial-labial, or axial-lingual), and how it is repositioned 9,12) . Therefore, in the present case, calcium hydroxide was not used to induce mineralized apical barrier formation, as it has disadvantages when compared with MTA 2,3,5) .…”

“…Intrusive luxation is one of the most difficult types of dentoalveolar trauma to manage and obtain a favorable prognosis for 9) . Its consequences include pulp tissue necrosis or calcification, dentoalveolar ankylosis, and defects in root development, such as root resorption 9,15) .…”

“…Its consequences include pulp tissue necrosis or calcification, dentoalveolar ankylosis, and defects in root development, such as root resorption 9,15) . Some studies have indicated that only three strategies are available for the Case Report doi:10.2209/tdcpublication.2017-0002 treatment of immature teeth affected by traumatic intrusion in the permanent dentition: spontaneous re-eruption, orthodontic repositioning, or surgical repositioning 7,9,15) . One of the most common complications of intrusive luxation is pulp necrosis, and when it affects a tooth with incomplete root formation, root development is inhibited 9,15) .…”

“…Some studies have indicated that only three strategies are available for the Case Report doi:10.2209/tdcpublication.2017-0002 treatment of immature teeth affected by traumatic intrusion in the permanent dentition: spontaneous re-eruption, orthodontic repositioning, or surgical repositioning 7,9,15) . One of the most common complications of intrusive luxation is pulp necrosis, and when it affects a tooth with incomplete root formation, root development is inhibited 9,15) . In such cases, apexification is required to induce the formation of a calcified barrier in the root apex 5) .…”

Intrusive Dislocation in Permanent Teeth: Review of Literature and Clinical Case Report

“…Despite its low prevalence, which corresponds to 1.9 % to 3 % of all traumatic lesions, intrusive dislocation is considered one of the most severe forms, which can produce catastrophic damage to the alveolar bone, severe shearing, gingival fibers rupture, periodontal ligament cells destruction, as well as crushing of the apical neurovascular system (Erverdi & Kargül, 2002;Güngör et al, 2006;Dias et al;Gomes et al, 2013). This trauma can generate serious 1 Students of the Specialization Course in Endodontics, Brazilian Association of Dentistry -ABO / GV-Governador Valadares, MG, Brazil.…”