Authors of section

Editors

J Andreasen, CP Cornelius, N Gellrich, S Hillerup, K Kusumoto, W Schubert

Executive Editors

Edward Ellis III, Kazuo Shimozato

General Editor

Daniel Buchbinder

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Tooth luxation with displacement - Intrusion

Definition and clinical appearance

An intrusion represents the most severe injury to the dentition as a result of the damage to gingival attachment, contusion of the periodontal ligament and bone, and, in immature teeth, damage of the tooth root forming structures (Hertwig’s epithelial root sheath). An intruded primary tooth may damage the underlying permanent tooth bud.

The intrusion is the result of a direct axial impact on the incisal edge. The tooth is pushed into the alveolar ridge, whereby the blood supply of pulp is severed (1) and the periodontal ligament is crushed (2). The tooth is locked into the bone.

Note:
Tooth intrusion is associated with major risk of loss of the tooth, which in most cases is due to replacement resorption (ankylosis).

Clinically, the tooth is not in alignment in the dental arch (infraposition). In most cases it is squeezed into the jaw. Percussion elicits a hard metallic sound. There is bleeding from the periodontal sulcus.

Intrusion

Clinical findings

The left central maxillary incisor is intruded in half its crown length in apical direction.

Intrusion

Axial view of the same patient.

Intrusion

Radiographic findinds

Following intrusive luxation, the entire periodontal ligament will be torn, and the ligament space will not be discernable in most cases.

Radiographic imaging may include orthopantomogram (OPG), intraoral dental films or cone beam/CT imaging.

X-ray shows the same patient.

Intrusion