A 5-year-old is brought in after trauma with a primary maxillary central incisor intruded approximately 4 mm. What is the appropriate management?

Correct answer: D. Monitor and allow spontaneous re-eruption

• A. Active repositioning and splinting is the protocol for an intruded PERMANENT tooth in certain circumstances, not for the primary dentition.
• B. Endodontic treatment is not indicated at presentation — it is a response to subsequent necrosis, if that develops.
• C. Extraction is indicated only if the apex is displaced toward or into the permanent tooth germ. Routine extraction of an intruded primary incisor causes unnecessary loss and may itself injure the follicle.
• D. CORRECT. For an intruded PRIMARY incisor, the IADT recommendation is to allow SPONTANEOUS RE-ERUPTION, which typically begins within a few weeks and completes over 6–12 months. Extraction is reserved for a tooth displaced INTO the permanent follicle (determined radiographically, usually with a lateral view). Follow-up is at 1 week, 6–8 weeks, 6 months and 1 year, watching for pulp necrosis, infection, or failure to re-erupt.

Note: Key discriminator: direction of displacement. Labial displacement (apex away from the follicle) → monitor. Palatal displacement (apex toward the follicle) → extract.