Management of intruded primary teeth after traumatic injuries

Intrusions occur frequently in the primary dentition. It has been reported that conservative treatment of the intruded primary tooth is preferred if the apex is away from the permanent tooth germ. Conservative treatments include waiting for spontaneous re-eruption, and surgical re-positioning and fixation. Few papers have been published in Japan comparing the prognoses of intruded primary teeth between these two different modes of treatment. Therefore, optimal treatment for intruded primary teeth has been a topic of controversy among clinicians. The aim of this study was to compare the outcomes of intruded primary teeth between these two modes of treatment. Moreover, we examined the issue of treatment of choice for intruded primary teeth. The subjects consisted of 17 children referred to the Hiroshima University Hospital Department of Pediatric Dentistry for the treatment of 21 intruded primary teeth. Fourteen teeth were allowed to spontaneously re-erupt (group W), and 7 teeth were repositioned and fixed (group R). Antibiotic therapy and irrigation were performed in all intruded teeth. Treatment outcomes were evaluated using the following parameters: re-eruption, pathological pulp changes, increased mobility, discoloration, pulp canal obliteration, pathological root resorption, and disturbances of permanent teeth. In group W, root canal treatment or extraction were not performed since re-erupted teeth reveal no signs of infection. On the other hand, in group R, 57% of teeth required endodontic treatment or extracted due to signs of infection. The result showed treatment outcomes in group R were worse than those in group W. Our study indicates that most intruded primary teeth re-erupt with a favorable prognosis. Therefore, observation with irrigation and antibiotic therapy should be the treatment of first choice.