Prognosis of Intrusive Luxation in Immature Permanent Teeth: A Report of Two Cases

Intrusive luxation is one of the most severe traumatic dental injuries in children and is associated with a high risk of pulpal necrosis, inflammatory root resorption, marginal bone loss, and compromised periodontal healing. Prognosis is multifactorial and depends on pre‑injury factors (age, stage of root development), injury‑related factors (severity of intrusion, number of teeth involved, presence of alveolar fracture and gingival lacerations), and treatment‑related factors (time to intervention, repositioning method, splinting, and endodontic management). Hereby, the authors present two cases (a 9-year-old and a 10-year-old girl) of severe intrusive luxation in immature permanent maxillary incisors managed with immediate surgical repositioning and flexible splinting. Despite similar pre‑injury characteristics and timely management, the outcomes differed. Case 1 demonstrated uneventful soft-tissue healing, maintenance of pulp vitality, and stable periodontal support without radiographic evidence of inflammatory root resorption. In contrast, case 2 developed progressive gingival recession, interdental bone loss, inflammatory root resorption, and severe mobility of the completely intruded lateral incisor, necessitating extraction. The remaining immature incisors underwent apexification, with subsequent improvement in periodontal attachment and successful prosthetic rehabilitation. A comparative analysis is presented to highlight how the magnitude of traumatic force, associated alveolar fracture, and severity of gingival laceration can influence prognosis and guide clinical decision‑making in immature permanent teeth.