Trauma can result in the displacement of teeth into the bone (intrusion), partially out of the socket (extrusion), or in another direction (lateral luxation). For intruded permanent teeth with immature root formation, the objective is to allow for spontaneous eruption. Intruded permanent teeth with complete root formation may be repositioned surgically or orthodontically. Permanent teeth that have been extruded or luxated laterally need to be repositioned as soon as possible to optimize healing of the periodontal ligament and neurovascular supply. They should be stabilized by splinting in their anatomically correct position. Mature permanent teeth that have been displaced or loosened may undergo pulpal necrosis due to associated injuries to the blood vessels at the apex and, therefore, must be followed carefully.
After trauma, the permanent tooth should be evaluated for mobility before splinting is considered. Treatment may also include orthodontic repositioning. Parents should be advised that any injury to a permanent tooth may result in pulpal necrosis. Periodic reevaluation is indicated.
Luxated Permanent Tooth
Intruded Permanent Tooth
Extruded Permanent Tooth