Intrusive Luxation in Primary Teeth: A Case Report

Background: Intrusive luxation, also called central dislocation, is often the result of an axial impact in the apical direction, moving the tooth within the alveolar bone. This is possibly one of the most traumatic injuries, since the displacement of a tooth within its socket implies extensive and acute involvement of the periodontal ligament, bone damage and rupture of the neurovascular bundle. The close relationship between the apexes of the primary teeth and the developing permanent successor in turn can lead to multiple complications, which are greater when the permanent tooth is affected in the early stages of development. Methods: The present paper describes a case of intrusion in primary teeth and its evolution following initial diagnosis as avulsion at the time of trauma. Results: The upper right central incisor, initially diagnosed as avulsed, was lodged in the floor of the right nostril, and was surgically extracted through the nose. Conclusions: In cases of intrusion of primary teeth, it is essential to diagnose the direction of the displaced tooth to rule out injury to the successor and thus prevent the occurrence of sequelae in the permanent dentition.

tooth traumatism; primary dentition

1. Andreasen JO, Ravn JJ. The effect of traumatic injuries to primary teeth on their permanent successors. Eur J Oral Sci 79:284-94.1971.

2. Andreasen JO, Andreasen FM, Andersson L, editors. Textbook and color atlas of traumatic injuries to the teeth, 4th edn. Oxford: Blackwell; 2007.

3. García Ballesta C, Mendoza Mendoza A. Traumatología oral en odontopediatría: diagnóstico y tratamiento integral. Majadahonda, Madrid: Ergon; 2003.

4. Flores MT, Malmgren B, Andersson I, Andreasen JO, Bakland LK, Barnett F, et al. Guidelines for the management of traumatic dental injuries. III. Primary teeth. Dent Traumatol 23: 196-202. 2007.

5. Malmgren B, Andreasen JO, Flores MT, Robertson A, DiAngelis AJ, Andersson I, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries. III. Injuries in the primary teeth. Dent Traumatol 28: 174-82. 2012.

6. DiAngelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M, Sigurdsson A, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol 28: 2-12. 2012.

7. Norton E, O’Connell AC. Traumatic dental injuries and their association with malocclusion in the primary dentition of Irish children. Dent Traumatol 28:81–6. 2012.

8. Kramer PF, Zembruski C, Ferreira SH, Feldens CA. Traumatic dental injuries in Brazilian preschool children. Dental Traumatology 19:299-303. 2003.

9. Planells del pozo P., Salmeron Escobar J.I. Traumatismos en denticion temporal; en: Mendoza Mendoza A, García Ballesta C, Traumatología oral: diagnóstico y tratamiento integral. Soluciones esteticas. Majadahonda, Madrid: Ergon 371-393. 2012.

10. Tozoglu S, Yolcu U, Tozoglu U. Developmental disturbance of maxillary lateral incisor after trauma. Dental Traumatology 23:85-6. 2007.

11. Da Silva Assunção LR, Ferelle A, Iwakura MLH, Cunha RF. Effects on permanent teeth after luxation injuries to the primary predecessors: a study in children assisted at an emergency service. Dental Traumatology 25:165- 70. 2009.

12. Diab M eH. Intrusion injuries of primary incisors. Part I: Review and management. Quintessence Int 31:327-34. 2000.

13. Flores MT. Traumatic injuries in the primary dentition. Dental Traumatology 18:287-298. 2002.

14. Von Arx T. Developmental disturbances of permanent teeth following trauma to the primary dentition. Aust Dent J 38:1-10. 1993.

15. Andreasen FM, Andreasen JO. Diagnosis of luxation injuries: the importance of standardized clinical, radiographic and photographic techniques in clinical investigations. Endod Dent Traumatol 1:160-9. 1985.

16. Mendoza Mendoza A. Manejo del paciente traumatizado. Exploración y diagnóstico de las lesiones; en: Mendoza Mendoza A, García Ballesta C, Traumatología oral: diagnóstico y tratamiento integral. Soluciones esteticas. Majadahonda, Madrid: Ergon 39-51. 2012.

17. Boorum MK, Andreasen JO. Sequelae of trauma to primary maxillary incisors. I. Complications in the primary dentition. Dental Traumatology 14:31-44. 1998.

18. de Amorim Lde F, da Costa LR, Estrela C. Retrospective study of traumatic dental injuries in primary teeth in a Brazilian specialized pediatric practice. Dent Traumatol 27:368–73. 2011.

19. Carvalho V, Jacomo DR, Campos V. Frequency of intrusive luxation in deciduous teeth and its effects. Dental Traumatology 26:304-7. 2010. 20. Küchler EC, da Silva Fidalgo TK, Farinhas JA, de Castro Costa M. Developmental dental alterations in permanent teeth after intrusion of the predecessors: clinical and microscopic evaluation. Dental Traumatology 26:505-8. 2010 .

21. Shaked I, Peretz B, Ashkenazi M. Development of odontoma-like malformation in the permanent dentition caused by intrusion of primary incisor? a case report. Dental Traumatology 24:e395-e7. 2008.

22. Holan G RD. Sequelae and prognosis of intruded primary incisors: a retrospective study. Pediatr Dent 21:242-7. 1999 .

23. Moura L de F, Bezerra AC, Amorim Lde F, Moura Mde D, Toledo Ode A. Intrusive luxation of primary teeth. Dental Traumatology 24:91-5. 2008.