For a mature tooth with intrusion greater than 7 millimeters, the recommended treatment includes

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When a mature tooth is intruded more than 7 mm, spontaneous re-eruption is unlikely and the tooth is typically nonvital with a high risk of complications. The best approach is surgical repositioning to quickly restore position and occlusion, followed by stabilization with a flexible splint for about four weeks to permit periodontal ligament and alveolar bone healing.

Because a mature tooth after such severe intrusion almost certainly loses pulpal vitality, root canal therapy should be started soon after repositioning—typically within three weeks—to prevent inflammatory root resorption and other pulp-related complications. Extraction is reserved only if the tooth is not restorable or the prognosis is hopeless. Performing repositioning without endodontic treatment leaves necrotic tissue that can drive ongoing damage, making combined surgical repositioning, splinting, and timely endodontic therapy the preferred plan.