Management of Luxated Permanent Incisors: A Study Between Orthodontic and Digital Repositioning

Purpose: This study aimed to evaluate clinical outcomes of digitally and orthodontically repositioned permanent incisors following extrusive and lateral luxation injuries. Methods: In this retrospective study, patient records from 105 permanent incisors with traumatic luxation injuries that were treated by means of digital (N equals 67) or orthodontic repositioning (N equals 38) were included. The main outcome was pulpal necrosis leading to the need for endodontic therapy. Cox-proportional regression was used to estimate the association between type of treatment and the main outcome, and a Kaplan-Meier plot comparing the survival of injured teeth in each group was obtained. Results: Most participants were boys (62 percent) with a mean age of 10 years. Fewer teeth in the orthodontic group (n equals eight versus n equals 27 in the digital) developed pulp necrosis requiring endodontic therapy (P=0.04). Although not statistically significant, multivariate analyses revealed that teeth treated by means of orthodontic reduction are less likely to develop pulpal necrosis (hazard ratio equals 0.47; 95 percent confidence interval equals 0.2 to 1.0). Conclusions: Acknowledging the limitations of this study, luxated permanent incisors treated via orthodontic repositioning may exhibit more favorable outcomes. Additional studies with various injuries are needed to establish universal adoption of management guidelines.