Dental intrusion

Intrusion is the term used to describe displacement of tooth into alveolar bone which is accompanied by fracture or crushing of alveolar bone so the crown appears shorter.

Clinical Features

• Displacement is accompanied by fracture or crushing of alveolar bone.
• Tooth is mobile.
• Bleeding from gingival crevice.
• Tooth is tender to percussion and masticatory forces.
• Clinically crown appears shorter.

Radiographic Features

• Obliteration of apical portion of PDL space.
• Crushing of lamina dura.

Treatment

• Spontaneous eruption, Orthodontic or surgical repositioning of tooth. The treatment lines for the management of intrusion depend on the degree of intrusion which has taken place.

1. In case of minor (1–2 mm) of intrusion it is best to wait up to 3 months for spontaneous eruption to occur before initiating any type of treatment.
2. In case of severe intrusion the two best mentioned approaches are orthodontic and surgical extrusion. The former is more methodical and is mostly indicated when the traumatized tooth have incomplete root/ apex formation. This approach would bring the tooth slowly into position without compromising the blood and nerve supply. However, the drawbacks of this technique are more time consuming, and can be used for isolated single teeth traumas.
3. The surgical extrusion is more rigid method of repositioning and provides immediate results and is indicated in multiple trauma but can lead to non-vitalization of teeth due to severing of blood supply.

• Suture the gingival laceration.
• Splint for 2 to 3 weeks after tooth has come to normal position.
• Soft diet for 14 days.
• Follow-up period of 1 year.

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