Abstract
Intrusion is more common in the primary dentition but is uncommon in permanent dentition. Decisions regarding treatment may vary according to the maturity of the root development and the severity of intrusion, though there is a lack of consensus concerning the management of intruded permanent teeth. Current management includes waiting for the tooth to re-erupt spontaneously, repositioning with orthodontic traction, and surgical repositioning. This paper describes orthodontic repositioning treatment of an immature intruded permanent central incisor. An 8-year-old boy was brought to the Pediatric Dental Clinic of Okayama University Hospital one day after the injury. Intraoral examination revealed intrusive luxation of the maxillary right central incisor (Tooth 11). Radiographic examination indicated that the tooth had an open apex and had been intruded approximately 5-6 mm relative to the adjacent left central incisor. The tooth was left for possible spontaneous re-eruption. However, after 3 weeks orthodontic extrusion was applied as an alternative treatment because no movement was evident. After 38 days, the extrusion was completed. This appliance was left in place for an additional three months for retention purposes and then removed. In follow-up radiographs taken one,two and three years after the extrusive traction, root canal obliteration was seen. No periapical radiolucency was observed. After a 3.7-year follow-up period, no signs of progressive root resorption, marginal bone loss, pulp necrosis or periapical lesions were observed. Regardless of the strategy, traumatically intruded teeth should undergo periodic clinical and radiographic surveillance on a long-term basis to allow early detection of possible complications.
