title: Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome.
abstract: OBJECTIVE
  Intrusive luxation in the permanent dentition is an uncommon injury but it is considered one of the most severe types of dental trauma because of the risk for damage to the periodontal ligament, pulp and alveolar bone. Management of intrusive luxation in the permanent dentition is controversial. The purpose of this study was to evaluate pulp survival and periodontal healing in intrusive luxated permanent teeth in relation to treatment alternatives, degree of intrusion and root development.
  
  
  METHODS
  The material consisted of 60 intruded permanent teeth in 48 patients (32 boys and 16 girls) aged 6-16 years (mean 9.4, median 9.0). The observation time was 6-130 months (mean 47.8, median 40.0). The analysed treatments were spontaneous re-eruption (17 teeth), orthodontic extrusion (12 teeth) and surgical reposition (31 teeth). The degree of intrusion was registered as mild (0-3 mm), moderate (4-6 mm) and severe (≥7 mm). Root development was categorized with respect to root formation and development of the apex into four stages; one-quarter to three-quarters root formation, full root formation with open apex, full root formation with half-closed apex and full root formation with apex closed. Ankylosis-related resorption with pulp necrosis was diagnosed in 20 teeth, ingrowth of bone apically in two teeth, pulp necrosis without ankylosis-related resorption in 23 teeth and pulp revitalization occurred in 15 teeth.
  
  
  RESULTS
  Significant correlations to the treatment outcome were root development (P = 0.03) and degree of intrusion (P = 0.03).
  
  
  CONCLUSIONS
  No firm conclusion could be drawn for the difference in outcome between orthodontic extrusion and surgical reposition. To conclude, evaluation of the prognosis for intruded teeth should be based on the stage of root development and degree of intrusion. In teeth with immature root development, no active treatment appears to result in fewer healing complications.
authors: Department of Paediatric Dentistry, Eastmaninstitutet Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska University Hospital, Huddinge, Dalagatan 11,Stockholm, Sweden. georgios.tsilingaridis@ki.se
authors: Georgios
authors: G
authors: Tsilingaridis
authors: Barbro
authors: B
authors: Malmgren
authors: Jens O
authors: JO
authors: Andreasen
authors: Olle
authors: O
authors: Malmgren
mesh_terms: D000293:Adolescent; D002648:Child; D003782:Dental Pulp / Q000293:injuries*; D003790:Dental Pulp Necrosis / Q000209:etiology*; D019229:Dentition, Permanent; D005260:Female; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging / Q000293:injuries*; D053208:Kaplan-Meier Estimate; D008297:Male; D010513:Periodontal Ligament / Q000293:injuries*; D016016:Proportional Hazards Models; D011859:Radiography; D012189:Retrospective Studies; D012391:Root Resorption / Q000209:etiology*; D014084:Tooth Avulsion / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000254:growth & development / Q000293:injuries*; D014945:Wound Healing