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Lateral Luxation Repositioning — ORE Part 1 MCQ

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ModeratePaediatric DentistryLateral Luxation RepositioningORE Part 1

A 7-year-old child attends immediately after trauma with a permanent maxillary central incisor displaced palatally. The tooth is immobile and locked in its displaced position. What is the most appropriate initial management?

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Correct answer: E — Reposition under local anaesthesia and apply a flexible splint for 4 weeks

This is lateral luxation of a permanent incisor: the palatal displacement and immobility indicate bony locking. The tooth should be promptly repositioned under local anaesthesia; disengagement of the apex from the cortical bone may require carefully controlled forceps assistance. It should then be stabilised with a flexible splint for 4 weeks to support periodontal healing. Orthodontic traction is not the acute method for reducing a mechanically locked lateral luxation. Observation alone leaves the tooth malpositioned and does not address the locked displacement. Extraction is inappropriate where conservative repositioning is feasible, particularly for a young permanent incisor. Occlusal adjustment alone may be adjunctive after repositioning if needed, but cannot correct the displacement.

Reference: Gomes et al. Lateral luxation: Is root resorption an unavoidable complication? 2022. https://pubmed.ncbi.nlm.nih.gov/35600017/