Complete traumatic intrusion of an upper deciduous incisor in a two year old: case report

Précis

Management of a completely intruded upper deciduous central incisor and factors to assess aside from tooth position when considering management options for such traumatic injuries.

Abstract

Traumatic intrusion is the apical displacement of a tooth into alveolar bone, which has the potential to cause significant complications for the developing permanent tooth germ behind. A two-year-old male presented to our oral and maxillofacial surgery department with a completely intruded upper right deciduous central incisor. There are a number of considerations in deciding whether to extract or monitor intruded deciduous teeth. When labially intruded, primary teeth may spontaneously re-erupt. Palatal intrusion is an indication for extraction. Other considerations such as soft tissue injury, risk of infection, presence of socket fracture and patient factors should be taken into account when planning treatment. In this report, we show the management of complete traumatic intrusion of an upper deciduous incisor. Aside from radiographic positioning, after reviewing this patient, we considered that the presence of socket fracture and high risk of infection alone indicted removal of this tooth. Extraction was performed under a general anaesthetic (GA) due to limited patient co-operation. In conclusion, although position is a key determinant of intrusion management, soft tissue injury, risk of infection, socket fracture and patient factors should also be used to guide the clinical decision whether to extract or monitor.

Journal of the Irish Dental Association 2018; 64 (4): 245-248.

Dr Úna McAuliffe
BDS (NUI) MFDS (RCSEd) MDPH (NUI)

Prof. Martin Kinirons
BDS (NUI) FDSRCS (ENG) FFDRCS (IRL) PhD (QUB)

Dr Noel Woods
PhD MATLHE MA (Economics) BA

Dr Máiréad Harding
BDS (NUI) MFGDP (UK) MPDH PgDipTLHE PhD (NUI)

Corresponding author: Dr Úna McAuliffe, Oral Health and Development Unit, Cork University Dental School and Hospital, University College Cork