Journal of Korean Dental Science

Korean Academy of Dental Science (대한치의학회)
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Management and Prognosis of Malpositioned Splinting in Lateral Luxation of Maxillary Central Incisors: A 31-Month Follow-up Case Report

  • Eunah Ann (Department of Pediatric Dentistry, Wonkwang University Daejeon Dental Hospital) ;
  • Heeyung Chang (Dentalspa Dental Clinic) ;
  • Jihyun Song (Department of Pediatric Dentistry, Wonkwang University Daejeon Dental Hospital)
  • Received : 2025.08.20
  • Accepted : 2025.09.29
  • Published : 2025.12.31
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Abstract

Objectives: Lateral luxation is a traumatic dental injury generally managed through prompt repositioning and splinting, which is essential for pulp and periodontal healing. But delays in treatment and anatomical constraints can complicate treatment. This report aims to describe the clinical course and prognosis of a case in which maxillary central incisors were inadvertently splinted in an incorrect position outside the socket and subsequently managed with regenerative endodontic treatment. Methods: A 7-year-old girl presented with laterally luxated maxillary central incisors that had been improperly splinted out of the socket at another local dental clinic. The malpositioning was identified 4 weeks post-trauma via cone-beam computed tomography, at which point repositioning was deemed difficult, and the immature teeth were under observation. Subsequently, regenerative endodontic treatment was performed because of pulpal necrosis and signs of inflammation. Results: At 31 months of follow-up after the injury, favorable healing outcomes were observed, including formation of the lamina dura, reduction in apical foramen diameter, increased clinical crown length, and the absence of clinical symptoms. Conclusion: This case demonstrates that, even when immature teeth remain incorrectly positioned after trauma and present with a lack of alveolar support and direct gingival exposure of the root apex, favorable outcomes can still be achieved following pulp therapy.

Keywords

Acknowledgement

This study was supported by Wonkwang University in 2025.

References

  1. Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O'Connell AC, Day PF, Tsilingaridis G, Abbott PV, Fouad AF, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol. 2020;36:314-30. https://doi.org/10.1111/edt.v36.4
  2. Patel S, Puri T, Mannocci F, Navai A. Diagnosis and Management of Traumatic Dental Injuries Using Intraoral Radiography and Cone-beam Computed Tomography: An In Vivo Investigation. J Endod. 2021;47:914-23. https://doi.org/10.1016/j.joen.2021.02.015
  3. Soares PBF, Vilela ABF, Moura CCG, Estrela C, Bueno MR, Soares CJ. Lateral Luxation of Incisor - A Case Report of Using a New Cone-Beam Computed Tomography Software and Reposition Guideline. Braz Dent J. 2020;31:337-43. https://doi.org/10.1590/0103-6440202003069
  4. Pelka M, Berthold C, van Waes H. Late reposition of a lateral luxated maxillary incisor with an immature apex. Dent Traumatol. 2009; 25: 550-4. https://doi.org/10.1111/edt.2009.25.issue-5
  5. Honorio HM, de Alencar CR, Pereira Junior ES, de Ol-iveira DS, de Oliveira GC, Rios D. Posttraumatic dis-placement management: lateral luxation and alveolar bone fracture in young permanent teeth with 5 years of follow-up. Case Rep Dent. 2015;2015:634237.
  6. Strobl H, Haas M, Norer B, Gerhard S, Emshoff R. Evaluation of pulpal blood flow after tooth splinting of luxated permanent maxillary incisors. Dent Traumatol. 2004;20:36-41. https://doi.org/10.1046/j.1600-4469.2003.00223.x
  7. Yu. CY, Abbott PV. Responses of the pulp, periradicular and soft tissues following trauma to the permanent teeth. Aust Dent J. 2016;61(Supp11):39-58. https://doi.org/10.1111/adj.2016.61.issue-S1
  8. Andreasen FM, Kahler B. Pulpal response after acute dental injury in the permanent dentition: clinical implications-a review. J Endod. 2015;41:299-308. https://doi.org/10.1016/j.joen.2014.11.015
  9. de Gregorio C, Tewari N. Management of Complications in Dental Traumatology. Dent Traumatol. 2025;41(Suppl 1):6471. https://doi.org/10.1111/edt.v41.S1
  10. Hu X, Wang Q, Ma C. Li Q-Zhao C. Xiang K. Is Etiology a Key Factor for R.egenerative Endodontic Treatment Outcomes? J. Endod. 2023; 49: 953-62. https://doi.org/10.1016/j.joen.2023.05.021
  11. Yan H, De Deus G, Kristoffersen IM, Wiig E, Reseland JE, Johnsen GF, Silva EJNL, Haugen HJ. Regenerative Endodontics by Cell Homing: A Review of Recent Clinical trials. J Endod. 2023;49:4-17. https://doi.org/10.1016/j.joen.2022.09.008
  12. Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. R. egenerative endodontics: a comprehensive review. Int Endod J. 2018; 51: 1367-88. https://doi.org/10.1111/iej.2018.51.issue-12
  13. Huang R, Zhou C, Zhan L, Liu Y, Liu X, Du Q Wang J, Zhao W, Song G, Wu LA, Jiang B, Li Y, Zhang H, Zou J. Experts consensus on management of tooth luxation and avulsion. Int J Oral Sci. 2024; 16: 57. https://doi.org/10.1038/s41368-024-00321-z
  14. Yoshihashi N. Feasibility and Outcomes of Cell-based Regenerative Endodontic Therapy in Postautogenous Transplantation of a Mature Tooth: A Case Report. J Endod. 2025;51:85-93. https://doi.org/10.1016/j.joen.2024.11.003
  15. Nyman S, Karring T, Lindhe J, Planten S. Healing fol-lowing implantation of periodontitis-affected roots into gingival connective tissue. J Clin Periodontol. 1980;7:394-401. https://doi.org/10.1111/cpe.1980.7.issue-5
  16. Nyman S, Gottlow Karring T, Lindhe The regenerative potential of the periodont: lligament. An experimental study in the monkey. J Clin Periodontol. 1982; 9: 257-65. https://doi.org/10.1111/cpe.1982.9.issue-3
  17. Vinagre A, Castanheira C. Messias A, Palma PJ, Ramos JC. Management of Pulp Canal Obliteration-Systematic Review of Case Reports. Medicina (Kaunas). 2021;57:1237. https://doi.org/10.3390/medicina57111237
  18. Bastos JV, Cortes MIS. Pulp canal obliteration after traumatic injuries in permanent teeth-scientific fact or fiction? Braz Oral Res. 2018;32(Suppl 1):e75. https://doi.org/10.1590/1807-3107bor-2018.vol32.0075
  19. Song M, Cao Y, Shin SJ, Shon WJ, Chugal N, Kim RH, Kim E, Kang MK. Revascularization-associated Intracanal Calcification: Assessment of Prevalence and Contributing Factors. J Endod. 2017;43:2025-33. https://doi.org/10.1016/j.joen.2017.06.018
  20. McCabe PS, Dummer PM. Pulp canal obliteration: an endodontic diagnosis and treatment challenge. Int Endod J. 2012; 45: 177-97. https://doi.org/10.1111/iej.2012.45.issue-2
  21. American Association of Endodontists. The recom-mended guidelines of the American Association of Endodontists for the treatment of traumatic dental injuries. Available from URL: https://www.aae.org/spe-cialty/wp-content/uploads/sites/2/2019/02/19Trau-maGuidelines.pdf (Accessedon December 13, 2025).
  22. Andreasen JO, Bakland LK, Andreasen FM. Traumatic intrusion of permanent teeth. Part 2. A clinical study of the effect of preinjury and injury factors, such as sex, age, stage of root development, tooth location, and extent of injury including number of intruded teeth on 140 intruded permanent teeth. Dent Traumatol. 2006; 22:90-8. https://doi.org/10.1111/edt.2006.22.issue-2
  23. Andreasen JO, Andreasen FM, Skeie A, Hjorting-Han-sen E, Schwartz O. Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries-a review article. Dent Traumatol. 2002; 18: 116-28. https://doi.org/10.1034/j.1600-9657.2002.00079.x
  24. Corputty Johan EM, Saputra FE. The evaluation of delayed treatment on dentoalveolar trauma by surgical reposition and wire-composite splint technique. J Int Dent Med Res. 2017;10:384-91.
  25. Lago L, da Silva L, Fernandez-Formoso N, Rilo B. Extrusive luxation. Therapeutic procedure. Clin Case Rep. 2023:11:e7289.