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