Spontaneous Re-eruption of Severely Intruded Immature Permanent Maxillary Central Incisors and Orthodontic Treatment

Intrusive luxation is a serious traumatic dental injury that causes significant damage to the periodontium, alveolar bone, and pulp.Severe intrusions are generally associated with poor prognoses and a high risk of complications.This report presents the successful spontaneous re-eruption of severely intruded immature permanent maxillary central incisors.An eight-year-old boy was referred with severe intrusion of the maxillary right and left central incisors to the gingival level, with an intrusion depth of approximately 7 mm-8 mm.In accordance with the International Association of Dental Traumatology (IADT) guidelines, a "wait-and-watch" approach was adopted.The teeth completely re-erupted spontaneously within 14 months of treatment.At the 36-month follow-up, after allowing for root maturation and periodontal stabilization, a removable orthodontic appliance was used to correct the palatal tipping of the right maxillary central incisor, a sequela of intrusive luxation.Over the 58-month follow-up period, no signs of pulp necrosis, root resorption, or ankylosis were observed.This case report supports the notion that severely intruded immature permanent incisors can undergo successful spontaneous re-eruption.Furthermore, this finding is consistent with emerging evidence suggesting that Cvek's classification may serve as a useful prognostic indicator of the potential for spontaneous re-eruption in immature permanent teeth.