Severe Intrusive Luxation of a Permanent Maxillary Central Incisor Managed Through an Interdisciplinary Approach Using Orthodontic Extrusion and Endodontic Therapy: A Five-Year Follow-Up

Intrusive luxation of a permanent maxillary central incisor is an uncommon yet highly challenging dental injury, often associated with extensive periodontal ligament (PDL) damage, pulpal necrosis, and an increased risk of root resorption. This case report details the comprehensive management of a severely intruded maxillary central incisor in a nine-year-old patient using controlled orthodontic extrusion. Clinical and radiographic evaluation confirmed significant apical displacement without evidence of crown or root fracture. Given the depth of intrusion and the stage of root development, orthodontic extrusion was chosen as a biologically conservative and predictable approach to reposition the tooth and support periodontal healing. Endodontic therapy was subsequently performed to prevent inflammatory root resorption. Over a five-year follow-up period, the tooth showed stable positioning, healthy periodontal support, and favourable aesthetic and functional outcomes. This case demonstrates the reliability of orthodontic extrusion as a minimally invasive and effective treatment modality for severe intrusive luxation injuries in permanent incisors.