A 12 year old male patient complains of pain in upper front teeth region and gives a history of fall while playing 30 minutes ago. Intra-oral examination reveals intrusion of maxillary right central incisor by 8 mm. What is the most appropriate treatment for this patient?
Correct Answer: Reposition surgically and stabilize for 4 to 8 weeks by means of a flexible splint with endodontic intervention.
Description: The treatment for a permanent tooth with a closed root end, and intruded less than 3 mm, is to allow the tooth to erupt without intervention. If no movement is evident after 2 to 4 weeks, the tooth may be repositioned either orthodontically or surgically before ankylosis can take place. If the tooth is intruded 7 mm or more, the tooth is repositioned surgically and stabilized for 4 to 8 weeks by means of a flexible splint. In most instances the pulp will become necrotic with intrusive injuries in teeth with complete root formation. Root canal treatment should be initiated, with calcium hydroxide as a temporary canal- filling material, 2 to 3 weeks after stabilization.
The treatment for an intruded permanent tooth with incomplete root formation is to allow it to erupt spontaneously. If no movement is seen within a few weeks, orthodontic repositioning should begin. If the tooth is intruded 7 mm or more, the tooth can be repositioned surgically and stabilized by means of a flexible splint. Endodontic therapy is often required, however, and the tooth should be monitored closely while a decision on endodontic therapy is pending.
Category:
Dental
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