Intrusive luxation of permanent incisors in Norwegians aged 6-17 years: a retrospective study of treatment and outcome

Abstract

Background/aim: External replacement resorption (ankylosis-related) is a severe complication leading eventually to tooth loss. Little information exists regarding the influence of variables such as degree of intrusion or treatment method on the development of replacement resolution in intruded permanent incisors. The aim of this study was to report the most frequently involved age group, the preferred type of treatment, and the type and frequency of healing complications. Special attention was paid to the effect of treatment on the occurrence of replacement resorption.

Material and methods: Fifty-one intruded permanent incisors were studied in 20 boys and 19 girls aged 6 to 17 years. Only three patients were over 12 years of age. Complete intrusion had occurred in 21 teeth, and 31 teeth were classified as immature. Re-eruption was awaited for 37 teeth. The remaining teeth were repositioned orthodontically (7 teeth) or surgically (7 teeth).

Results: Re-eruption occurred in 35 out of 37 teeth over a period of 3-12 months. After a mean observation period of 4 years ranging from 1-12 years, retained pulp vitality was recorded in 22 teeth (43%). Pulp necrosis had developed in 57%, inflammatory resorption in 26% and replacement resorption in 12%. Whereas all inflammatory resorptions were arrested after long-term calcium hydroxide treatment, replacement resorption always led to complete root resorption. In the analysis all orthodontic and surgical repositioned teeth were combined into an active treatment group. The non-active treatment group consisted of teeth allowed to re-erupt. The distribution of replacement resorption was significantly lower in teeth allowed to re-erupt than in teeth repositioned actively.

Conclusions: The best treatment of intruded incisors in 6-12 year-old children is to await re-eruption. Should endodontic treatment be required before re-eruption has occurred, a gingivectomy can be performed to gain access to the root canal.