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Extrusive Luxation — ORE Part 1 MCQ

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ModerateOral SurgeryExtrusive LuxationORE Part 1

A 12-year-old child attends immediately after falling from a bicycle. Her permanent upper right central incisor has sustained an extrusive luxation and is displaced coronally by 3 mm. What is the most appropriate immediate management?

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Correct answer: C — Digitally reposition, then apply a flexible splint for 2 weeks

The correct answer is C. An extrusively luxated permanent incisor should be repositioned promptly, usually with gentle digital pressure under local anaesthesia if needed, and stabilised with a passive flexible/semi-rigid splint for 2 weeks. This restores position while permitting physiological movement during periodontal healing. Observation leaves the tooth displaced and mobile. Extraction is inappropriate where the tooth is repositionable. A rigid splint for 6 weeks is excessive for uncomplicated extrusive luxation; prolonged rigid immobilisation is not the recommended approach. Orthodontic traction is not an emergency treatment for an acutely extruded tooth and would unnecessarily delay reduction.

Reference: Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dental Traumatology. 2020. https://pubmed.ncbi.nlm.nih.gov/34925679/