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A combined approach with passive and active repositioning of a traumatically intruded immature permanent incisor.

BACKGROUND
Severe damage to the tooth, periodontal ligament, and pulpal tissue often occurs with intrusive luxation, and outcomes are quite unpredictable because of the variable ways in which the injury may occur, which influences both the choice of treatment and prognosis.


CASE REPORT
This case presents a novel method for the management of an intruded permanent maxillary central incisor with an immature apex. At first, watchful waiting for spontaneous re-eruption was the chosen treatment option. A palatal gingivectomy was performed and endodontic access was established, following which, an intracanal medicament of calcium hydroxide was applied. A root canal treatment was completed, and apexification with mineral trioxide aggregate was performed. Re-eruption failed to reach completion, so complete repositioning was performed with the aid of orthodontics for two months.


CONCLUSION
The present case illustrates the partial re-eruption of a severely intruded immature permanent tooth with the use of interim medication in the root canal. This case also shows complete re-eruption with the aid of timely orthodontic repositioning after apexification.