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Trauma

399 - Management of Traumatic Intrusion with Open Apex : A Multidisciplinary Approach

Saturday, May 23, 2026
2:30 PM - 2:45 PM PST
Has Audio

    Presenting Author(s)

  • Anushka Parakh, BDS

    Resident
    University of Connecticut Health Ctr & Connecticut Children's Med Ctr
    University of Connecticut
    Bloomfield, Connecticut, United States

    • Research Mentor(s)

  • JR

    Jorge Rabat, DDS

    Associate Professor
    University of Connecticut
    University of Connecticut
    Farmington, Connecticut, United States

    • Program Director(s)

  • RP

    Rosa E. Pelaez-Shelton, DDS,MDS

    Assistant Professor
    University of Connecticut Health Ctr & Connecticut Children's Med Ctr
    Farmington, Connecticut, United States

Abstract:

Background: Traumatic dental injuries in growing patients with immature permanent teeth present unique clinical challenges due to open apices and incomplete root development. This case describes the multidisciplinary management of an intruded maxillary permanent incisor with an open apex in an 8-year-old patient.

Case Description: An 8-year-old patient presented with intrusion of tooth #8 following dental trauma. Consistent with AAPD guidelines, spontaneous re-eruption was initially advised. The patient subsequently underwent surgical extrusion and splinting performed by the oral surgery team. Approximately 10–11 months later, the patient returned with extrusion of tooth #8 by 5–6 mm. The patient exhibited a Frankl behavior rating of 2, limiting cooperation for in-office care. The case was planned for comprehensive oral rehabilitation under general anesthesia. An endodontic consultation recommended apexification to promote apical barrier formation and maintain the tooth, despite a guarded prognosis. The patient’s parent expressed a strong preference for preserving the natural tooth. Under general anesthesia, apexification, core buildup, and definitive restoration of tooth #8 were completed.

Results: In this case, Biodentine provided a practical single-visit solution in a patient for whom revascularization was not realistic because of behavioral limitations. Follow-up demonstrated apical closure and periapical healing, supporting its use as an alternative to MTA.

Conclusion: This case highlights the significance of individualized treatment planning and interdisciplinary collaboration in managing traumatic dental injuries with open apices, particularly in behaviorally challenged pediatric patients.



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