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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (1): 148-153. doi: 10.19723/j.issn.1671-167X.2025.01.022

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Factors associated with spontaneous re-eruption of traumatically intruded permanent anterior teeth in children and adolescents

Minting DENG1, Nan WANG2, Bin XIA1, Yuming ZHAO1, Junxia ZHU1,*()   

  1. 1. Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
    2. Department of Dentistry, Peking University Third Hospital, Beijing 100191, China
  • Received:2024-10-09 Online:2025-02-18 Published:2025-01-25
  • Contact: Junxia ZHU E-mail:pkusszhujunxia@163.com

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Abstract:

Objective: To analyze the factors related to spontaneous re-eruption after intruded injury in permanent anterior teeth in children and adolescents. Methods: Clinical data from 5- to 17-year-old patients who sustained intrusive luxation of permanent anterior teeth and treated in the Department of Pedia-tric Dentistry of Peking University School and Hospital of Stomatology from June 2015 to August 2024 were reviewed. Information of age, gender, degree of intrusion, direction of intrusion, tooth development, concomitant injuries, luxation and post-osteoclastic eruption of the adjacent teeth were recorded. The patients were divided into two groups based on whether they showed spontaneous re-eruption during advised observation after intrusion. Univariate and multifactor analysis were performed using Logistic regression. Results: Data from 170 teeth in 139 patients whose age ranging from 5.3-16.3 years [mean age (9.0± 2.1) years] were examined. A gender disparity was observed among the patients, with 84 being male and 55 being female. Among the 170 teeth, 112 were categorized as successfully spontaneous re-eruption during advised observation after intrusion, while 58 were not. In terms of the degree of intrusion, 45 teeth (26.47%) had intrusion less than 3 mm, 102 teeth (60.00%) experienced intrusion between 3-7 mm, and 23 teeth (13.53%) were faced with intrusion exceeding 7 mm. As for the direction of intrusion, 117 teeth (68.82%) were straight intrusion while mesial-distal and buccal-lingual intrusion respectively accounting for 17 (10.00%) and 23 (13.53%). Multivariate Logistic regression analysis showed that mesial-distal intrusion (OR=0.167, 95%CI: 0.031-0.9048, P=0.038), intrusion of >7 mm (OR=0.065, 95%CI: 0.014-0.299, P < 0.001) and luxation of adjacent teeth (OR=0.369, 95%CI: 0.144-0.944, P=0.037) were independent risk factors for spontaneous re-eruption of traumatically intruded permanent anterior teeth in children and adolescents during advised observation after intrusion, while intrusion of < 3 mm (OR=9.860, 95%CI: 2.430-40.009, P=0.001) and post-osteoclastic eruption of adjacent teeth (OR=4.712, 95%CI: 1.528-14.531, P=0.007) were independent protective factors. The possibility of spontaneous re-eruption in permanent anterior teeth during advised observation after intrusion was decreased by 61.1% with the increase of root development using Cvek' s classification (OR=0.611, 95%CI: 0.408-0.914, P=0.017). Age (OR=1.077, 95%CI: 0.763-1.521, P=0.673) and laceration of gingival (OR=0.865, 95%CI: 0.290-2.578, P=0.794) didn't significantly affect the spontaneous re-eruption during advised observation after intrusion. Conclusion: In this study, mesial-distal intrusion, intrusion of >7 mm and luxation of adjacent teeth were independent risk factors for spontaneous re-eruption of traumatically intruded permanent anterior teeth in children and adolescents during advised observation, while intrusion of < 3 mm and post-osteoclastic eruption of adjacent teeth were served as independent protective factors.

Key words: Tooth avulsion, Permanent dentition, Tooth eruption, Risk factors, Child, Adolescent

CLC Number: 

  • R788.4

Figure 1

Intra-oral picture and periapical radiograph of traumatically intruded permanent anterior teeth A, intra-oral picture at the time of injury; B, intra-oral picture after 1 month of injury; C, periapical radiograph at the time of injury; D, periapical radiograph after 1 month of injury."

Table 1

Univariate Logistic regression analysis of spontaneous re-eruption in traumatically intruded permanent anterior teeth"

Variables Spontaneous re-eruption P
Total (n=170) No (n=58) Yes (n=112)
Age/years, ${\bar x}$±s 9.20±2.15 9.98±2.48 8.80±1.84 0.002
Degree of intrusion, n(%) < 0.001
   < 3 mm 45 (26.47) 3 (5.17) 42 (37.50)
  3-7 mm 102 (60.00) 37(63.79) 65(58.04)
  >7 mm 23(13.53) 18 (31.03) 5(4.46)
Direction of intrusion, n(%) < 0.001
  Straight 117 (68.82) 24(41.38) 93 (83.04)
  Buccal-lingual 36 (21.18) 20(34.48) 16 (14.29)
  Mesial-distal 17 (10.00) 14 (24.14) 3 (2.68)
Post-osteoclastic eruption of the adjacent teeth, n(%) < 0.001
  No 99(58.24) 49(84.48) 50(44.64)
  Yes 71(41.76) 9(15.52) 62(55.36)
Laceration of gingival, n(%) < 0.001
  No 125 (73.53) 32 (55.17) 93 (83.04)
  Yes 45 (26.47) 26 (44.83) 19 (16.96)
Luxation of adjacent teeth, n(%) < 0.001
  No 75 (44.12) 12 (20.69) 63 (56.25)
  Yes 95 (55.88) 46 (79.31) 49(43.75)
Cvek’s classification, n(%) 0.009
  Stage 1 9 (5.29) 1 (1.72) 8 (7.14)
  Stage 2 27 (15.88) 7 (12.07) 20 (17.86)
  Stage 3 48 (28.24) 12 (20.69) 36 (32.14)
  Stage 4 31 (18.24) 9 (15.52) 22 (19.64)
  Stage 5 55 (32.35) 29 (50.00) 26 (23.21)
Complex crown fracture, n(%) 0.895
  No 156 (91.76) 53 (91.38) 103 (91.96)
  Yes 14 (8.24) 5 (8.62) 9 (8.04)

Table 2

Multivariate Logistic regression analysis of spontaneous re-eruption in traumatically intruded permanent anterior teeth"

Variables β SE Wald χ2 P OR (95%CI)
Age 0.074 0.176 0.178 0.673 1.077 (0.763-1.521)
Degree of intrusion
  3-7 mm 1.00 (Reference)
  >7 mm -2.727 0.776 12.354 < 0.001 0.065 (0.014-0.299)
   < 3 mm 2.288 0.715 10.255 0.001 9.860 (2.430-40.009)
Direction of intrusion
  Straight 1.00 (Reference)
  Buccal-lingual -0.980 0.519 3.566 0.059 0.374 (0.136-1.038)
  Mesial-distal -1.793 0.863 4.313 0.038 0.167 (0.031-0.904)
Cvek’s classification -0.493 0.205 5.748 0.017 0.611 (0.408-0.914)
Laceration of gingival
  No 1.00 (Reference)
  Yes -0.145 0.557 0.068 0.794 0.865 (0.290-2.578)
Luxation of adjacent teeth
  No 1.00 (Reference)
  Yes -0.997 0.479 4.331 0.037 0.369 (0.144-0.944)
Post-osteoclastic eruption of the adjacent teeth
  No 1.00 (Reference)
  Yes 1.550 0.575 7.277 0.007 4.712 (1.528-14.531)
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