Orthodontic management of intrusive and lateral luxation of permanent incisors: a scoping review

Intrusive and lateral luxations are among the most severe traumatic dental injuries affecting permanent maxillary incisors in children and adolescents. Their management remains complex and controversial, with orthodontic repositioning increasingly regarded as a conservative alternative to surgical or manual methods. This scoping review aimed to map current evidence on orthodontic repositioning for these injuries, emphasizing treatment protocols, clinical outcomes, and the influence of root development on prognosis. A scoping search of PubMed, Embase, Scopus, and Web of Science was conducted up to July 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Eligible studies included case reports and case series on orthodontic repositioning of intrusive and/or lateral luxations in permanent maxillary incisors of patients aged ≤18 years. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist for case reports. Fourteen studies comprising 16 patients and 23 affected incisors were included. Eight teeth exhibited closed apices (CA) and 15 had open apices (OA). Orthodontic strategies varied; most employed light, continuous forces via multibracket appliances. All CA teeth and 10 OA teeth underwent root canal treatment, while 5 OA teeth healed without intervention (3 developed pulp canal obliteration, and 2 maintained sensibility). Reported complications included pulp necrosis (n = 11), root resorption (n = 4), ankylosis (n = 2), and pulp canal obliteration (n = 3), but overall tooth survival remained high. Although the methodological quality was acceptable, substantial heterogeneity existed in treatment protocols and follow-up durations. Orthodontic repositioning appears to be biologically favorable and minimally invasive for managing intrusive and lateral luxations of permanent maxillary incisors, particularly when surgical repositioning is not feasible. Prognosis is influenced by root maturity, treatment timing, biomechanics, and trauma severity. Well-designed prospective studies are warranted to establish standardized, evidence-based protocols for pediatric patients.