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Management of traumatically intruded young permanent tooth with 40‐month follow‐up
Author(s) -
Chacko V,
Pradhan M
Publication year - 2014
Publication title -
australian dental journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 71
eISSN - 1834-7819
pISSN - 0045-0421
DOI - 10.1111/adj.12164
Subject(s) - medicine , pulp necrosis , dentistry , root canal , periodontal fiber , asymptomatic , pulp (tooth) , incisor , maxillary central incisor , resorption , molar , dental trauma , orthodontics , surgery , pathology
Background Intrusive luxation injuries often result in severe damage to the tooth, periodontal ligament and pulpal tissue. Furthermore, treatment outcome is often unpredictable because of the large number of injury related variables which influence choice of treatment and prognosis. This report presents the case of a 9‐year‐old boy with a 6 mm intruded permanent maxillary central incisor with an open apex. Methods The treatment option chosen was to wait and watch for ‘spontaneous re‐eruption’. At the end of two weeks, the tooth showed signs of pulp necrosis and external root resorption. A palatal mucoperiostal flap was reflected and endodontic access was established, following which an intracanal medicament of calcium hydroxide was applied. By the end of the fifth month, there was radiographic evidence of apical barrier formation and by the tenth month, the tooth had re‐erupted to the level of the adjacent central incisor. Root canal treatment was completed at the end of 24 months and the root was reinforced using a glass fibre post. Results At the last follow‐up visit (40 months after trauma), the tooth was asymptomatic and radiographic examination showed satisfactory periapical and periodontal healing. Conclusions Spontaneous re‐eruption is possible, even in severely intruded teeth with open apices.