Intrusion

Question 1

What tissues are damaged following an intrusive injury?

Answer 1

Pulp and supporting structures, as tooth has been driven into alveolar process due to an axially directed impact

Question 2

Why is diagnosis difficult in mixed dentition?

Answer 2

Intrusion can mimic a tooth under eruption

Question 3

What is most important factor when deciding on treatment?

Answer 3

Tooth maturity is, mature tooth will undergo pulp necrosis

Question 4

How many immature teeth will die?

Answer 4

Around half and once again it may be a late complication

Question 5

What other factors are important when deciding on treatment?

Answer 5

Percussion is suggested and it is worth asking parents if they think tooth looks shorter/whether they have any recent photographs that can be compared, and

Question 6

What is treatment of intrusion of an immature tooth?

Answer 6

Allow spontaneous eruption (also called Passive Repositioning), monitor pulp status radiographically at 3, 4 and 6 weeks, 6 months, extirpate pulp and place non setting calcium hydroxide if resorption is seen, and if no movement after 3 weeks, orthodontic repositioning is recommended

Question 7

What is treatment of intrusion of a mature tooth?

Answer 7

Passive repositioning works for some mild cases, but orthodontic repositioning is required if there is no eruption at 2-3 weeks, elective pulp extirpation after 2 weeks and calcium hydroxide dressing is appropriate for moderate and severe intrusions, and root fill once periodontal healing is established