Sequelae and prognosis of intruded primary incisors: a retrospective study

Resident’s Name: Brian Schmid Date: 8/21/09
Article title: Sequelae and prognosis of intruded primary incisors: a retrospective study
Author(s): Gideon Holan DMD, Diana Ram Odo.
Journal: Pediatric Dentistry
Month, Year: March 1999
Major topic: See title.
Type of Article: Retrospective.
Overview of method of research: Chart analysis.
Findings: Teeth can be partially or completely intruded. The apex is most often pushed labially, but can be palatal. In most cases the tooth will re-erupt within 1-6 months without any pathologic sequences. Complications may include pulp necrosis, periapical inflammation, external root resorption, ankylosis, pulp canal obliteration (PCO) and fusion with the crown of the permanent tooth bud. Boys experience tooth luxation more often at a rate of 1.7:1. 57% had a single intruded primary incisor, 34% had two, 4% had three and 5% had four. 58% were partially intruded, 39% completely intruded. 80% of apices were pushed labially. 68% of the teeth survived more than 36 months. For those that required extraction the reasons were: periodontal breakdown 27%, repeated trauma 5%. Complete intrusion lead to periodontal breakdown more often than partial. Fracture of the labial plate did not affect the outcome. Of the teeth that survived, 88% re-erupted fully, 10% did not return to the occlusal plane and 2% failed to re-erupt due to ankylosis. 63% of teeth re-erupted to normal position, ectopic positioning occurred in the remaining 37%, rotation being the most common malposition but with no additional pathologic sequelae. There was no difference between partial and complete intrusion influencing the ability of the tooth to re-erupt. Radiographs of re-erupted teeth were also reviewed: 33% had normal pulps, 52% had PCO and was more likely to occur in completely intruded teeth vs. partially intruded (64% vs 40%). 7 teeth were suspected to have undergone pulp necrosis, 6 of which were extracted, 1 surviving post endodontic treatment. Antibiotics given post trauma did not affect the outcome. Hx of trauma prior to the accident did not affect the outcome. 27% of untreated teeth eventually required extraction.
Assessment of article: Very dry and is largely a list of percentages but with a respectable study size it is worth reviewing to support your treatment decisions and to inform parents.