EXTRUSION INJURY TREATMENT OF CENTRAL INCISOR: CASE REPORT

Aim: Dental traumas range from simple enamel fractures to avulsions caused by forces beyond the physiological limits of teeth and surrounding tissues. Extrusion injury is a type of trauma where the tooth is partially displaced out of the alveolar bone, causing elongation and potential tissue damage. Treatment involves repositioning the tooth, applying a splint, and regularly monitoring pulp vitality through clinical and radiographic exams during healing.

Case Presentation: A healthy 8-year-old girl came to our clinic 24 hours after falling off a bicycle, complaining of pain and elongation in her upper left central incisor. Examination showed swelling and laceration on the upper lip, bleeding near teeth #11 and #21, about 1 mm extrusion of tooth #21, increased mobility, pain on palpation and percussion, and no response to vitality testing. Radiographs revealed more than two-thirds root development with an open apex and no fractures. The area was rinsed with saline, and tooth #21 was repositioned with finger pressure and stabilized using a flexible splint made from 0.25 mm fishing line between the canines. Due to pain on closing the jaw, occlusion was raised with compomer restorations on the first molars to protect tooth #21. The patient was advised to eat a soft diet and maintain oral hygiene.After two weeks, the splint and restorations were removed. Follow-ups at 1, 3, 6, 9, and 12 months showed negative cold test responses until month 6, with positive responses at months 9 and 12. Radiographs at 12 months showed no symptoms and complete apex closure.

Result: In teeth with open apices suffering from extrusion injuries, an initial negative response to vitality testing does not necessarily indicate pulpal necrosis. Close clinical and radiographic follow- up before initiating pulp therapy can result in favorable outcomes.

Keywords: Trauma, Extrusion Injury, Pediatric Dentistry