title: Management of traumatically intruded young permanent tooth with 40-month follow-up.
abstract: 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.
authors.affiliation: Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal University, Mangalore, India.
authors.forename: V
authors.initials: V
authors.lastname: Chacko
authors.forename: M
authors.initials: M
authors.lastname: Pradhan
mesh_terms: D002126:Calcium Hydroxide / Q000008:administration & dosage; D002648:Child; D003782:Dental Pulp; D003790:Dental Pulp Necrosis / Q000209:etiology / Q000628:therapy; D019229:Dentition, Permanent; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000293:injuries*; D008297:Male; D008437:Maxilla; D010513:Periodontal Ligament / Q000293:injuries; D012390:Root Canal Therapy / Q000379:methods; D012391:Root Resorption / Q000209:etiology; D014084:Tooth Avulsion / Q000150:complications / Q000601:surgery*; D014078:Tooth Eruption / Q000502:physiology; D014092:Tooth Root / Q000293:injuries; D057832:Watchful Waiting
chemical_list: D002126:Calcium Hydroxide
keywords: Intrusion; open apex; trauma