Orthodontic repositioning of traumatically intruded permanent incisors - A report of three cases

Abstract

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.