Clinical and Radiographic Evaluation of Intrusion in Primary Teeth by the Dental Trauma

Abstract

Intrusive luxation is caused by an impact in the axial direction by which the tooth is displaced into the alveolar bone. It usually affects the primary dentition and can generate sequalae. Its treatment is defined by clinical and radiographic signs. Objective: to follow intrusive primary teeth and observe sequela occurrence. Methods: Dental records of patients with a history of alveolodental trauma were evaluated and records from patients that had suffered intrusion with at least a two-year follow-up period were selected. Intrusion and reeruption degrees, dental mobility occurrence, coloration and tooth position after reeruption, fistula occurrence, pulp canal and periapical region condition, root resorption occurrence and treatment performed were checked. Results: Out of 435 treated patients, 83 intrusion cases were found, 29 of which were included in the sample, totaling 39 traumatized primary teeth. Thus, intrusion represented 19.1% of the analyzed traumas. Although females were more affected (55.2%) than males, a correlation between sex and traumatized primary teeth was not found. With reference to affected teeth, the most affected was tooth 61 (34.4%), followed by tooth 51 (31.0%). Also, in 31.0% of the cases, the two central upper incisives were affected. The study showed that fall from height was the prevailing etiology, encompassing 58.6 % of the cases. Out of the total, 27 teeth showed total reeruption, 3 presented a 2/3 reeruption of the crown, and 9 either exfoliated or were extracted. Upon observing sequelae, dental discoloration was most frequent, having been encountered in 23 teeth (79.3%). As to treatment, 28 out of 39 teeth were only followed up (71.8%), 9 needed endodontic treatment (23.1%) and 2 extraction (5.1%). Conclusion: the monitoring of the spontaneous reeruption of intruded teeth and the careful observation to determine sequela occurrence are the best choices, once complications might arise several months after trauma. Sequelae and inclusion degree are closely related, inasmuch as the higher the intrusion degree, the greater the sequela severity; thus, professional follow-up is indispensable.