Traumatic Extrusive and Lateral Luxation of Maxillary Incisors During Orthodontic Treatment: A Multidisciplinary Management Approach.

Background/

Objectives

Traumatic dental injuries involving the maxillary anterior teeth are common; however, combined extrusive and lateral dislocation during active orthodontic treatment is uncommon and presents unique management challenges. This case report describes the multidisciplinary management of traumatic extrusive and lateral dislocation of the maxillary right lateral incisor (#7) and maxillary right central incisor (#8) in a 27-year-old patient undergoing fixed orthodontic treatment following sports-related trauma.

Methods

Clinical examination revealed marked coronal and lateral displacement, pathologic mobility, gingival laceration, active bleeding, and deformation of the orthodontic archwire. Both affected teeth had complete root formation. Emergency management included immediate repositioning of the displaced teeth and urgent endodontic treatment. Semi-rigid stabilization was achieved using metallic ligatures and a rectangular stainless-steel orthodontic archwire, supplemented by temporary skeletal anchorage with a mini-screw and posterior bite turbos to reduce occlusal loading. The patient was monitored clinically and radiographically throughout healing and subsequent orthodontic treatment.

Results

Follow-up examinations demonstrated favorable periodontal healing, stable retention of the traumatized teeth, absence of pathologic mobility, and successful continuation of orthodontic treatment. Radiographic evaluation showed no evidence of inflammatory root resorption or other significant complications. At the 16-month follow-up, the affected teeth remained functional and stable, and implant placement was successfully completed at the congenitally missing maxillary canine site.

Conclusions

This case highlights the importance of immediate interdisciplinary management of traumatic dental dislocation during orthodontic treatment. Fixed orthodontic appliances, when appropriately incorporated into emergency stabilization protocols, may contribute to successful tooth retention and favorable long-term outcomes.