Orthodontic repositioning of traumatically intruded permanent incisors - A report of three cases
Intrusive luxation of permanent teeth is one of the most serious traumatic dental injuries involving damage to the gingival tissue, periodontal ligament, cementum, bone and to the neurovascular supply of the pulp. In addition to disruption of normal tooth development and eruption, it can also lead to pulpal necrosis, root resorption and marginal bone loss. Based on the extent/severity, intrusion maybe classified into mild (<3 mm), moderate (3-6mm) and severe (>6mm). Available techniques for managing intrusive luxation include a wait-and-watch approach to allow for spontaneous re-eruption, orthodontic traction and surgical repositioning. The type of treatment approach employed depends upon the stage of root development, severity of intrusive luxation and the presence or absence of alveolar fractures. It is difficult to predict reliable outcomes with these approaches, since the presence of variables such as the severity of intrusion, associated crown/root fracture, stage of root development and presence of alveolar fractures may alter the prognosis. The present article presents a series of three cases with intrusive luxation of permanent incisors successfully treated using an interdisciplinary approach involving orthodontic traction along with endodontic rehabilitation.
2. Omar S, Freccia WF, Retamozo B, Bakland LK. Traumatically intruded permanent teeth: Three case reports and a review of current recommendations. J Calif Dent Assoc. 2017; 45(5): 235-43.
3. Carvalho V, Jacomo DR, Campos V. Frequency of intrusive luxation in deciduous teeth and its effects. Dent Traumatol 2010; 26(4): 304-7.
4. Andreasen JO, Bakland LK, Andreasen FM. Traumatic intrusion of permanent teeth. Part 3. A clinical study of the effect of treatment variables such as treatment delay, method of repositioning, type of splint, length of splinting and antibiotics on 140 teeth. Dent Traumatol. 2006; 22: 99-111.
5. Al-Badri S, Kinirons M, Cole BOI, Welbury RR. Factors affecting resorption in traumatically intruded permanent incisors in children. Dent Traumatol. 2002; 18: 73-6.
6. Kinirons MJ. Treatment of traumatically intruded permanent incisor teeth in children, UK National clinical guidelines in Pediatric Dentistry. Int J Pediatr Dent. 1998; 8: 165-8.
7. Humphrey JM, Kenny DJ, Barrett EJ. Clinical outcomes for permanent incisor luxations in a pediatric population. I Intrusions. Dent Traumatol. 2003; 19: 266-73.
8. Stewart C, Dawson M, Shafi I, Kinirons M, Welbury R. A study of the management of 55 traumatically intruded permanent incisor teeth in children. Eur Archives Pediatr Dent. 2009; 10(1): 25-8.
9. DiAngelis AJ, Andreasen JO, Ebelesesder KA, Kenny DJ, Trope M, Sigurdsson A, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 2012; 28: 2-12.
10. Calasans-Maia JA, Calasans-Maia MD, Matta ENR, Ruellas ACO. Orthodontic movement in traumatically intruded teeth: a case report. Dent Traumatol. 2003; 19: 292-5.
11. Turley PK, Crawford LB, Carrington KW. Traumatically intruded teeth. Angle Orthod 1987; 57(3): 234-44.
12. Andreasen FM, Vestergaard PB. Prognosis of luxated permanent teeth- the development of pulp necrosis. Endod Dent Traumatol. 1985; 1: 205-20.
13. AlKhalifa JD, AlAzemi AA. Intrusive luxation of permanent teeth: A systemic review of factors important for treatment decision making. Dent Traumatol. 2014; 30: 169-75.
14. Chaushu S, Shapira J, Heling I, Becker A. Emergency orthodontic treatment after the traumatic intrusive luxation of maxillary incisors. Am J Orthod Dentofacial Orthop. 2004; 126(2): 162-72.
15. Andreasen FM, Zhijie Y, Thomson BL. Relationship between pulp dimension and development of pulp necrosis after luxation injuries in the permanent dentition. Endod Dent Traumatol. 1986; 2: 90-8.
16. Andreasen JO, Bakland LK, Matras RC, Andreasen FM. Traumatic intrusion of permanent teeth. Part 1. An epidemiological study of 216 intruded permanent teeth. Dent Traumatol. 2006; 22: 83-9.
17. Seddon RP. Concomitant intrusive luxation and root fracture of a central incisor - report of a case. Endod Dent Traumatol. 1997; 13: 99-102.
18. de Alencar AH, Lustosa-Pereira A, de Sousa HA, Figueiredo JH. Intrusive luxation a case report. Dent Traumatol 2007; 23: 307-12.
19. Chacko V, Pradhan M. Management of traumatically intruded young permanent tooth with 40-month follow-up. Austr Dent J. 2014; 59: 240-4.
20. Ebeleseder KA, Santier G, Glockner K, Hulla H, Pertl C, Quenhenberger F. An analysis of 58 traumatically intruded and surgically extruded permanent teeth. Endod Dent Traumatol. 2000; 16: 34-9.
21. Andreasen FM, Yu Z, Thomsen BI. The relationship between pulpal dimensions and the development pulp necrosis after luxation injuries in the permanent dentition. Endod Dent Traumatol. 1996; 2: 90-8.
22. Ingle JI, Bakland LK, Baumgartner JC. Endodontic considerations in dental trauma in Ingle’s Endodontics, 6th Edition, BC Decker Inc, Hamilton: 2008, 1330-57.
23. Fields HW & Christensen JR. Orthodontic procedures after trauma. J Endod. 2013; 39(3S): S78-S87.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright for all articles is retained by the author/s of the individual articles.