An 8-year-old has an intruded permanent maxillary incisor with an immature, open apex. What is the preferred management?

Correct answer: B. Allow spontaneous re-eruption and monitor

• A. Extraction of a permanent incisor in an 8-year-old is unjustified for an intrusion injury and creates a lifelong prosthetic problem.
• B. CORRECT. For an immature tooth with an OPEN apex, IADT guidelines favour allowing spontaneous re-eruption regardless of the degree of intrusion. Open-apex teeth have substantial potential for both spontaneous re-eruption and pulpal revascularization, and intervening surgically adds trauma that reduces both.
• C. Orthodontic extrusion is the fallback if no spontaneous movement occurs within about four weeks, not the initial approach.
• D. Surgical repositioning is reserved for mature, closed-apex teeth or for open-apex teeth that fail to move — it is not the first choice here.

Note: IADT intrusion summary — OPEN apex: allow spontaneous re-eruption; if no movement in 4 weeks, reposition orthodontically. CLOSED apex: under 3 mm allow spontaneous re-eruption then intervene at 8 weeks; 3–7 mm reposition orthodontically or surgically; over 7 mm reposition surgically. Closed-apex teeth will almost always need endodontic treatment started within 2 weeks.