A Case Of Long-Term Intrusive Luxation Treatment

This report details the management of a 13-year-old male with intrusive luxation and alveolar bone fracture in maxillary central incisors after a 1-week delay. Prompt repositioning, fixation, and apexification resulted in root preservation and apical bone formation at 3 months, despite marginal bone resorption. The case highlights the urgency of emergency intervention for traumatic dental injuries A healthy 13-year-old male presented with pain, swelling, and malodor 1 week after maxillary central incisors (11, 21) intrusion. Clinical examination revealed complete tooth displacement, gingival lacerations, purulent discharge, and grade I mobility. CBCT confirmed obliterated periodontal ligament spaces, root canal widening, and labial alveolar plate fracture with bony fragments. Treatment Protocol Under local anesthesia, teeth were extracted, irrigated with saline, and repositioned using 0.6 mm stainless steel ligature wires. Root canal treatment began 1 week postoperatively with calcium hydroxide, followed by Vitapex obturation at 2 weeks. Follow-up at 8 weeks showed periodontal ligament continuity and osseous healing, with marginal bone resorption. Complete stability was achieved at 3 months. Successful outcomes relied on prompt debridement, ligament preservation, and endodontic management. Marginal bone resorption may stem from alveolar discontinuity, incomplete fragment removal, insufficient fixation, and poor hygiene. Young patients’ regenerative capacity likely minimized severe complications like ankylosis. Delayed treatment of intrusive luxation risks alveolar damage and psychosocial impact. Standardized emergency protocols, interdisciplinary collaboration, and patient education are essential. Future research should focus on optimizing treatment algorithms and reducing sequelae in complex dentoalveolar injuries.