Management of traumatic intrusion of permanent teeth with immediate surgical repositioning: A case report from Hasan Sadikin Hospital, Bandung-Indonesia

Traumatic dental injuries (TDI) of permanent teeth frequently occur in children and young adults. Intrusive luxation is one of the most severe forms of traumatic injuries in which the affected tooth is forced to displace deeper into the alveolus. As a consequence of this type of injury, maximum damage occurs to the pulp and all the supporting structures. The aim of this study is for proper diagnosis, treatment planning and follow up for improving a favorable outcome. Case: A 14 years old male patient came to the emergency department of Hospital Dr. Hasan Sadikin with bleeding from mouth due to an accident. Through clinical and radiographic examination discovered there was an intrusion of teeth 11,21. The intruded teeth were immediately repositioned and splinted within hours following injury with Arch Bar. Antibiotic therapy was initiated at the time of repositioning and maintained for five days. The splint was removed one month later. Clinical and radiographic examination one month after the surgical extrusion revealed satisfactory progressive apical and periodontal healing. Intrusion injuries have the poorest prognosis and complex treatment among all tooth injuries. No consensus has been reached on the optimal treatment of this type of injuries. The recommended treatment options for intruded teeth include the following such as allowing spontaneous re-eruption of the teeth, immediate surgical repositioning, and fixation and orthodontic repositioning. The treatment has to be adaptable according to complications. Conclusion: Further surgical repositioning in the presented case with one month follow up proved to be a viable treatment method for intruded teeth without any additional risk of resorption.