Intrusive luxation of primary incisor — ORE Part 1 MCQ

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HardPaediatric DentistryIntrusive luxation of primary incisorORE Part 1

A 4-year-old child is seen immediately after a fall. A maxillary primary incisor appears shortened and displaced palatally, with bleeding from the gingival sulcus. It is uncertain clinically whether the tooth is intruded or has sustained a crown-root fracture. What is the most appropriate initial investigation?

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Correct answer: C — An anterior periapical or occlusal radiograph

Explanation lettering: E = shown as B · D = shown as C · B = shown as D · C = shown as E

D is correct. Suspected intrusion of a primary incisor requires an anterior intra-oral periapical or occlusal radiograph. This confirms whether the tooth is intruded rather than fractured, demonstrates the displacement and helps assess its relationship to the developing permanent incisor, which may influence management and follow-up. A posterior bitewing does not adequately image the injured anterior region. Electric pulp testing is unreliable in young children and is not the priority in acute luxation diagnosis. CT is not routine dental imaging for an uncomplicated isolated primary-tooth intrusion and would expose the child to unnecessary radiation. Observation alone is inappropriate before diagnosis and baseline assessment; although many intruded primary incisors subsequently re-erupt, they require review for complications.

Reference: Day PF et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dental Traumatology. 2020. https://pubmed.ncbi.nlm.nih.gov/32458553/