Management of intrusive luxation with immediate surgical repositioning

Surgical Extrusion of Anterior Teeth with Intrusion Traumatic Injury: A Report of two Cases

Intrusion is the most severe luxation injury type, which results in both soft and hard tissue damage. In severe intrusions, the crown must be re-positioned in the arch to avoid periapical pathology and marginal bone loss. There is minimal information about the effect of treatment delay on pulpal and periodontal healing in intrusion trauma. The present paper reports on two cases of severe intrusive luxation applied late at different times treated with surgical extrusion. The first patient, an 11-year-old female, referred to Tokat GOP pediatric dentistry clinic three days after the intrusion tooth 21. The second patient, a 13-year-old male, referred to our clinic fifteen days after a traffic accident. The intruded teeth were positioned surgically and splinted. Surgical extrusion should be preferred as soon as possible to initiate root canal treatment in teeth, the crown of which is fully embedded in the alveolar bone.

Surgical extrusion as a treatment option for crown-root fracture in permanent anterior teeth: a systematic review

BACKGROUND

A crown-root fracture is defined as a fracture involving enamel, dentin, and cementum. The possibility of saving and reconstructing teeth with such fractures has increasingly become a viable alternative to extraction and prosthetic therapy. One such treatment option available is surgical extrusion.

OBJECTIVE

The aim of this review is to evaluate surgical extrusion as a treatment modality for management of crown-root fractures in permanent anterior teeth.

METHODS

Electronic search of scientific papers was carried out on Entrez Pubmed and the Cochrane Central Register of Controlled Trials databases using specific keywords. The search yielded 130 papers, out of which 16 relevant papers were identified and included based on predetermined inclusion criteria and the remaining 114 were found to be irrelevant. Hand search yielded 10 articles, which were also included. These 26 articles which included only case reports and case series formed the basis of this systematic review.

CONCLUSION

From the existing literature, we can conclude that surgical extrusion can be used to treat crown-root fractures successfully. But the level of evidence is very low as the studies available are only case reports and case series.

Management of traumatic intrusive luxation of incisors in a patient with Down's syndrome

Special needs individuals are children or adults who are prevented by a physical or mental condition from full participation in the normal range of activities of their age groups. They usually exhibit high treatment needs because of an increased prevalence and severity of trauma. This paper presents a case report and review of treatment strategy of repositioning, splinting of permanent incisors in a 13-year-old boy with Down's syndrome sustaining trauma led to intrusive luxation of maxillary incisors. The intruded incisors were immediately repositioned and splinted with composite within hours.