A novel multidisciplinary approach for the treatment of an intruded immature permanent incisor

The optimal treatment for intruded permanent teeth has not yet been determined. The ideal treatment option is the one with the lowest probability of developing complications such as external root resorption and marginal bone loss. Each case should be considered individually, bearing in mind the severity of the intrusion, the stage of root development, and tooth mobility. Management of an intruded permanent tooth may consist of: (1) observation for spontaneous eruption; (2) surgical crown uncovering; (3) orthodontic extrusion (with or without prior luxation of the intruded tooth); (4) and partial surgical extrusion, immediately followed by orthodontic extrusion and surgical repositioning. The purpose of this article was to review the treatment options for intruded immature permanent incisors, and to present a new modality of an elective internal strengthening of the immature root weakened by external root resorption. A case of an intrusive luxation injury in a 7 1/2-year-old child and the resulting complications utilizing this technique is described. This is the first known report in the pediatric dentistry literature of performing an elective (preventive) internal strengthening of an immature root weakened by severe external inflammatory resorption. The child was followed for 5 years with an excellent clinical outcome. This technique should be considered for treatment of immature permanent teeth with thin cervical root dentin and external or internal root resorption due to trauma or caries.