509 - Management of Severe Intrusive Injury in Immature Incisor with Revascularization

Traumatic intrusion is considered one of the most severe dentoalveolar injuries; however, there is limited research detailing the management and treatment of these injuries, particularly in immature permanent teeth. This case report describes the management of a severe traumatic intrusion presenting with an uncomplicated crown fracture, pulp necrosis, and external root resorption in a 7-year-old African American female. The left maxillary central incisor (tooth #9) was intruded approximately 10mm and inaccessible. The tooth was orthodontically repositioned for five months prior to initiating a regenerative endodontic procedure under oral sedation. Clinical and radiographic examinations during the follow-up period showed cessation of the resorption process and discontinuation of signs and symptoms. This case demonstrates that severe intrusive injuries in immature permanent teeth can be effectively managed with revascularization even when initiation of revascularization must be delayed due to extended time needed for orthodontic repositioning.