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Budak L, Sarao SK, Levin L. Fragment rehydration, splinting, and autotransplantation: A journey to better treatment for traumatized teeth. Dent Traumatol 2024; 40:1-4. [PMID: 38213107 DOI: 10.1111/edt.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
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Huang JW, Gan YN, Xu H, Han S, Zhu H, Jia L, Li N, Li DD, Cai ZG. Tooth intentional replantation from 1964 to 2023: A bibliometric analysis. Dent Traumatol 2024; 40:121-132. [PMID: 37646307 DOI: 10.1111/edt.12884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND/AIM There is no thorough overview of intentional tooth replantation techniques. We performed a bibliometric analysis of the development of intentional tooth replantation. MATERIALS AND METHODS A comprehensive search of the Web of Science and SCOPUS databases was conducted in February 2023. Original articles and reviews of human studies with "intentional replantation" or synonyms in the titles, abstracts, or keywords were included. A descriptive analysis of bibliographic data, co-occurrence analysis, and coupling of publications was performed. Multivariate analysis was used to explore the bibliometric parameters associated with the citation counts. RESULTS The study included 171 papers, which were co-authored by 500 individuals affiliated with 217 institutions from 28 countries/regions. The USA contributed the greatest number of publications, followed by China, and Japan. The USA had 694 citations, followed by Japan (210), and Turkey (210). The Journal of Endodontics and Dental Traumatology contributed the most citations. Five directions for future research were identified based on the coupling relationships of publications, including "managing vertical root fractures with adhesive resin using the intentional replantation technique," "intentional replantation for periodontally hopeless or endodontically compromised teeth," "intentional replantation for treating abnormalities of morphological development," "outcomes and prognosis factors of intentional replantation," and "treating root replacement resorption by intentional replantation." Multivariate analysis showed that the publication year, Journal Citation Reports ranking of journals, study design, and disease type were predictors of citation counts. CONCLUSIONS This bibliometric analysis provides a comprehensive description of the intentional replantation technique. The USA published the greatest volume of papers and generated the most citations. The Journal of Endodontics and Dental Traumatology are considered the most influential. The Journal Citation Reports journal ranking (Q1, Q2), study design (case reports, cohort studies), and disease type (crown root fractures) were associated with the citation counts.
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Affiliation(s)
- Jin-Wei Huang
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry II, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ye-Na Gan
- Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - He Xu
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Sheng Han
- Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - He Zhu
- Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Lu Jia
- Dental Laboratory Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Nan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Duo-Duo Li
- Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi-Gang Cai
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
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Park SH, Paek SH, Kim B, Lee JT. Assessment of Bone Height Changes Based on the Cone-Beam Computed Tomography Following Intentional Replantation for Periodontally Compromised Teeth. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010040. [PMID: 36676664 PMCID: PMC9864039 DOI: 10.3390/medicina59010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
Background and Objectives; This study aimed to evaluate the clinical outcomes and bone changes before and after intentional replantation (IR) for periodontally compromised teeth by using cone-beam computed tomography (CBCT). Materials and Methods; Fourteen periodontally involved teeth were selected for IR. A preoperative orthodontic procedure was performed to apply luxation, and the tooth was then gently extracted. Retrograde filling of the root-end canal was performed. Once the tooth was repositioned in the socket, it was splinted with the adjacent tooth. After three months, prosthetic restoration was performed. Results; Clinical parameters and CBCT images were obtained before and after the IR procedure. The height of the alveolar bone was measured on the CBCT images by using software. Most preoperative symptoms, including pain, mobility, probing depth (PD) and bleeding on probing (BOP), significantly decreased after IR (pain: 4.71 to 1.00; mobility: 1.36 to 0.29; PD: 5.60 to 2.85; BOP: 3.50 to 0.79). CBCT analysis indicated an increase in bone height after IR (the amount of change: maxilla, 4.00; mandible, 1.95). Conclusions; A previous study reported that IR for periodontally involved teeth is quite limited. However, in this study, IR of periodontally compromised teeth showed favorable results in clinical and radiographic evaluations, suggesting that IR may be an alternative to extraction of teeth with periodontal disease.
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Affiliation(s)
- So-hyun Park
- Department of Advanced General Dentistry, Dankook University Jukjeon Dental Hospital, Yongin-si 16890, Republic of Korea
| | - Seung-Heon Paek
- Department of Advanced General Dentistry, Dankook University Jukjeon Dental Hospital, Yongin-si 16890, Republic of Korea
| | - Bongju Kim
- Dental Life Science Research Institute, Seoul National University Dental Hospital, Seoul 03722, Republic of Korea
- Correspondence: (B.K.); (J.-T.L.)
| | - Jung-Tae Lee
- Department of Periodontics, One-Stop Specialty Center, Seoul National University, Dental Hospital, Seoul 05698, Republic of Korea
- Correspondence: (B.K.); (J.-T.L.)
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Intentional Replantation of Single-Rooted and Multi-Rooted Teeth: A Systematic Review. Healthcare (Basel) 2022; 11:healthcare11010011. [PMID: 36611471 PMCID: PMC9819326 DOI: 10.3390/healthcare11010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
The technique of intentional replantation can provide a second chance to save teeth that would be destined for extraction. Therefore, the present systematic review aimed primarily to estimate tooth survival after intentional replantation and secondarily to compare treatment outcomes in single-rooted and multi-rooted teeth. The study protocol was developed before the analysis according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Articles were electronically searched in PubMed/MEDLINE, the COCHRANE library and Google Scholar by two independent reviewers, and those that met the eligibility criteria were included. A statistical analysis using the chi-square test with a p-value of <0.05 was performed on the reported outcomes of intentional replantation. A total of 44 single-rooted replanted teeth with five failures (11.36%) and 42 multi-rooted replanted teeth with six failures (14.28%) were reported in the literature, corresponding to a survival rate of 88.64% and 85.57%, respectively. The overall survival rate for the replantation procedure was 86.7%, indicating that intentional replantation can be considered a safe therapeutic choice, with no statistically significant difference between the survival rates of single-rooted and multi-rooted replanted teeth.
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Shah PK, El Karim IA, Duncan HF, Nagendrababu V, Chong BS. Outcomes reporting in systematic reviews on surgical endodontics: A scoping review for the development of a core outcome set. Int Endod J 2022; 55:811-832. [PMID: 35553439 DOI: 10.1111/iej.13763] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evidence-informed decision-making in healthcare relies on the translation of research results to everyday clinical practice. A fundamental requirement is that the validity of any healthcare intervention must be supported by the resultant favourable treatment outcome. Unfortunately, differences in study design and the outcome measures evaluated often make it challenging to synthesise the available research evidence required for secondary research analysis and guideline development. Core outcome sets (COS) are defined as an agreed standardised set of outcomes which should be measured and reported as a minimum in all clinical trials on a specific topic. The benefits of COS include less heterogeneity, a reduction in the risk of reporting bias, ensuring all trials contribute data to facilitate meta-analyses, and given the engagement of key stakeholders, it also increases the chances that clinically-relevant outcomes are identified. The recognition of the need for COS for assessing endodontic treatment outcomes lead to the development of Core Outcome Sets for Endodontic Treatment modalities (COSET) protocol, which is registered (No. 1879) on the Core Outcome Measures in Effectiveness Trials (COMET) website. OBJECTIVES The objectives of this scoping review are to: (1) identify the outcomes assessed in studies evaluating surgical endodontic procedures; (2) report on the method of assessment used to measure the outcomes; (3) and assess selective reporting bias in the included studies. The data obtained will be used to inform the development of COS for surgical endodontics. METHODS A structured literature search of electronic databases and the grey literature was conducted to identify systematic reviews on periradicular surgery (PS), intentional replantation (IR) and tooth/root resection (RR), published between January 1990 and December 2020. Two independent reviewers were involved in the literature selection, data extraction and the appraisal of the studies identified. The type of intervention, outcomes measured, type of outcomes reported (clinician- or patient-reported), outcome measurement method, and follow-up period, were recorded using a standardised form. RESULTS Twenty-six systematic reviews consisting of 19 studies for PS, three studies for IR and four studies for RR were selected for inclusion. Outcome measures identified for PS and IR included pain, swelling, mobility and tenderness, outcomes related to periodontal/soft tissue healing (including sinus tract), periradicular healing, tooth survival, life impact (including Oral-Health-Related-Quality-of-Life), resource use and/or adverse effects. For RR, in addition to tooth survival, endodontic complications, and adverse effects, the outcome measures were primarily periodontal-related, including pocket depth reduction, attachment gain, periodontal disease, and periodontic-endodontic lesions. The majority of outcome measures for PS, IR, and RR were assessed clinically, radiologically and/or via patient history. Specific tools such as rating scales (Visual Analog Scale, Verbal rating Scale, Numerical Rating Scale, and other scales) were used for the assessment of pain, swelling, and tenderness, and validated questionnaires were used for the assessment of oral health-related quality of life. The range of follow-up periods were variable, dependent on the outcome measure and the type of intervention. CONCLUSIONS Outcome measures, method of assessment and follow-up periods for PS, IR and RR were identified and categorised to help standardise the reporting of outcomes for future research studies. Additional outcome measures that were not reported, but may be considered in the COSET consensus process include loss of root-end filling material, number of clinic visits, surgery-related dental anxiety and muco-gingival aesthetic-related measures, such as scarring, black triangles, root surface exposure, and tissue discolouration.
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Affiliation(s)
- Pratik Kamalkant Shah
- Institute of Dentistry, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Ikhlas A El Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Henry Fergus Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Bun San Chong
- Institute of Dentistry, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
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Cunliffe J, Ayub K, Darcey J, Foster-Thomas E. Intentional replantation - a clinical review of cases undertaken at a major UK dental school. Br Dent J 2020; 229:230-238. [PMID: 32855480 DOI: 10.1038/s41415-020-1988-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction Intentional replantation (IR) may offer a solution for persistent periapical lesions associated with endodontically treated teeth in select cases. This case series demonstrates the use of IR as an alternative treatment approach to both orthograde and surgical endodontic retreatment. The indications, contraindications, benefits and risks of IR are discussed, and the clinical procedure is outlined.Setting Restorative Department, University Dental Hospital of Manchester, UK.Case reports Of the 13 cases presented, the follow-up period before discharge ranged from 3-28 months. Only one tooth which presented intra-operative challenges required extraction three months after IR due to post-operative mobility.Conclusion In select cases, IR may provide a simple, less invasive and cost-effective alternative to both endodontic retreatment and extraction alone following appropriate training.
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Affiliation(s)
- Joanne Cunliffe
- Senior Lecturer/Honorary Consultant, University of Manchester, UK.
| | - Khawer Ayub
- Speciality Registrar in Restorative Dentistry, King's College Hospital and William Harvey Hospital, UK
| | - James Darcey
- Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, UK
| | - Emma Foster-Thomas
- Academic Clinical Fellow in Restorative Dentistry, University of Manchester, UK
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Wang L, Jiang H, Bai Y, Luo Q, Wu H, Liu H. Clinical outcomes after intentional replantation of permanent teeth: A systematic review. Bosn J Basic Med Sci 2020; 20:13-20. [PMID: 30684952 PMCID: PMC7029209 DOI: 10.17305/bjbms.2019.3937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022] Open
Abstract
This study aimed to systematically assess the outcomes of intentional replantation (IR) of teeth and to determine the survival rate, success rate, and prognostic factors related to the treatment. A search was conducted for all relevant English language articles published from January 2000 to October 2017. The search terms included "intentional replantation" and "teeth" according to the inclusion criteria. The Methodological Index for Non-randomized Studies (MINORS) was used to assess the methodological quality of included studies. Twelve studies were identified as relevant for the systematic review. In total, 896 patients with 905 teeth were examined for intentional teeth replantation. The success rate was greater than 90% in four studies (33.33%) and between 70% and 80% in five studies. At short-term follow-up (<6 months), the survival rate was approximately 90% in four studies. At longer-term follow-up (>36 months), the survival rates of teeth were slightly reduced in four studies, and tended to be stable after 48 months. In conclusion, the long-term success and survival rate of IR are likely dependent upon short extraoral time, reduced pocket depth, type of tooth, type of root-end filling material, and the prevention of atraumatic tooth root damage.
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Affiliation(s)
- Lin Wang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hua Jiang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Yang Bai
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Qiang Luo
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hao Wu
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hongchen Liu
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China.
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Abstract
Teeth are vital sensory organs that contribute to our daily activities of living. Unfortunately, teeth can be lost for several reasons including trauma, caries, and periodontal disease. Although dental trauma injuries and caries are more frequently encountered in a younger population, tooth loss because of periodontal disease occurs in the older population. In the dental implant era, the trend sometimes seems to be to extract compromised teeth and replace them with dental implants. However, the long-term prognosis of teeth might not be comparable with the prognosis of dental implants. Complications, failures, and diseases such as peri-implantitis are not uncommon, and, despite popular belief, implants are not 99% successful. Other treatment options that aim to save compromised or diseased teeth such as endodontic treatment, periodontal treatment, intentional replantation, and autotransplantation should be considered on an individual basis. These treatments have competing success rates to dental implants but, more importantly, retain the natural tooth in the dentition for a longer period of time. These options are important to discuss in detail during treatment planning with patients in order to clarify any misconceptions about teeth and dental implants. In the event a tooth does have to be extracted, procedures such as decoronation and orthodontic extrusion might be useful to preserve hard and soft tissues for future dental implant placement. Regardless of the treatment modality, it is critical that strict maintenance and follow-up protocols are implemented and that treatment planning is ethically responsible and evidence based.
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Clark D, Levin L. In the dental implant era, why do we still bother saving teeth? Dent Traumatol 2019; 35:368-375. [DOI: 10.1111/edt.12492] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Danielle Clark
- Division of Periodontology Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - Liran Levin
- Division of Periodontology Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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Deshpande NM, Shah D, Wadekar S. Maintenance of cell viability in extraoral conditions for a case of intentional replantation to retrieve a separated endodontic instrument. J Conserv Dent 2019; 22:207-212. [PMID: 31142995 PMCID: PMC6519190 DOI: 10.4103/jcd.jcd_461_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Intentional replantation has been used as an alternative treatment modality to tooth extraction and prosthetic replacement when conventional endodontic treatment modalities are unfeasible or contraindicated. This case report presents a successful case of intentional replantation for the mandibular first molar with an endodontic mishap. An endodontic instrument was separated in the apical third of the root canal and extended beyond its mesiobuccal root apex. Intentional replantation served as a means to remove the separated instrument. The periodontal ligament (PDL) cells were kept viable throughout the endodontic treatment using a distinctive technique, wherein a preoperative impression is used for continuous wetting with saline. Platelet-rich fibrin (PRF) was shredded and placed in the alveolar socket to enhance PDL cell reattachment and prevent ankylosis. The 2-year successful follow-up reinforced that intentional replantation can be a viable option for removal of separated instruments that lie beyond the root apex. The use of these techniques to keep PDL cells viable and the use of PRF can aid in prevention of ankylosis.
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Affiliation(s)
- Neha M Deshpande
- Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Dipali Shah
- Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Swati Wadekar
- Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
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Yang JM, Yang KI, Lee KH, Choi SH, Kim BO, Park JC, Yu SJ. Effects of platelet-rich plasma on tooth replantation in dogs: a histologic and histomorphometric analysis. J Periodontal Implant Sci 2018; 48:224-235. [PMID: 30202606 PMCID: PMC6125669 DOI: 10.5051/jpis.2018.48.4.224] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 08/19/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the effects of platelet-rich plasma (PRP) on periodontal healing of replanted root surfaces in dogs histologically and histomorphometrically. Methods A total of 36 roots of mandibular incisors and premolars from 6 mongrel dogs were used. The roots were randomly divided into 3 groups: 1) a positive control group (n=12), in which the periodontal ligament (PDL) and cementum were retained and the roots were soaked in saline; 2) a negative control group (n=12), in which the PDL and cementum were removed and the roots were soaked in saline; and 3) an experimental group (n=12), in which the PDL and cementum were removed and the roots were soaked in PRP. After soaking the root surfaces, the extracted roots were replanted into the extraction sockets. The roots were covered using a coronally repositioned flap Results Histologically, irregular-thickness PDL-like and cementum-like tissues were observed in the 4-week experimental group and the positive control group. PDL-like tissue and cementum-like tissue with a more uniform thickness were observed at 8 weeks. In the negative control group, PDL-like tissue and cementum-like tissue were rarely found, and root resorption and ankylosis were observed. In the cross-sectional histomorphometric analysis, the experimental group demonstrated a higher rate of formation of cementum-like tissue and a lower tooth ankylosis rate than the positive and negative control groups at 4 and 8 weeks. Although there was a significant difference in the tooth ankylosis rate and the formation of cementum-like tissue across the 3 groups (P<0.05), no statistical significance was observed between any pair of groups (P>0.017). Conclusions Applying PRP to root surfaces during tooth replantation in dogs can reduce tooth ankylosis and increase PDL-like and cementum-like tissue formation.
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Affiliation(s)
- Jun-Mo Yang
- Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea
| | - Keon-Il Yang
- Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea
| | - Kyung-Hyun Lee
- Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University School of Dentistry, Seoul, Korea
| | - Byung-Ock Kim
- Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea
| | - Joo-Cheol Park
- Department of Oral Histology/Developmental Biology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sang-Joun Yu
- Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea
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Deotale SP, Shewale AH, Gattani DR, Nathani AI, Banode AM. Reliability of two different protocols used for intentional re-implantation of periodontally hopeless teeth. J Indian Soc Periodontol 2018; 22:353-359. [PMID: 30131630 PMCID: PMC6077966 DOI: 10.4103/jisp.jisp_170_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/17/2018] [Indexed: 11/09/2022] Open
Abstract
Intentional re-implantation is the careful removal and re-insertion of an endodontically treated tooth performed with an attempt to preserve the natural dentition and patients' esthetic concerns. Its limited success rate and a possibility to obtain undesirable outcomes such as root resorption and ankylosis of the tooth restrict its clinical use to be attempted only as a last option after routine procedures. A vast array of procedures have been performed till date with inconsistent results due to lack of analogous protocols followed. Regardless of having a controversial background behind its success in periodontally compromised teeth, this procedure raises a hope to avoid unwarranted natural tooth loss. Performing each step with precision governs the success of the treatment. This case report demonstrates two different techniques with an interdisciplinary approach assessed over 1 year each.
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Affiliation(s)
| | | | - Deepti Rakesh Gattani
- Department of Periodontology, SDKS Dental College and Hospital, Nagpur, Maharashtra, India
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Hou G, Hou L, Weisgold A. Survival rate of teeth with periodontally hopeless prognosis after therapies with intentional replantation and perioprosthetic procedures - a study of case series for 5-12 years. Clin Exp Dent Res 2016; 2:85-95. [PMID: 29744154 PMCID: PMC5839187 DOI: 10.1002/cre2.25] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 01/14/2016] [Accepted: 02/01/2016] [Indexed: 12/17/2022] Open
Abstract
The purpose of the present study was to evaluate the longitudinal survival rate of the treatment of teeth affected with periodontally hopeless prognosis and secondary occlusal traumatism (SOT) using intentional replantation (IR) and periodontal prosthesis. We collected data from 17 individuals who received IR and participated in the study during 1995 to 2014. Of the 17 teeth affected by periodontally extreme conditions with deep angular bone defects, severe alveolar bone loss extending to or beyond the apex, and SOT, was recognized as having hopeless prognosis. Those teeth were treated sequentially using procedures that included basic periodontal therapy, therapeutic provisional prosthesis, IR, fixed dental prosthesis, crown and sleeve-coping telescopic dentures (CSCTDs), or fixed prosthesis and CSCTD combined. Longitudinal assessments of clinical parameters and radiographic bone change before and after IR were evaluated. Clinical results showed that the overall cumulative survival rate of assayed teeth after IR therapy (5-12 years) was 88.2%. The mean (±SD) estimated radiographic alveolar bone loss was 12.7 ± 2.1 mm (88.5% ± 13.3%) of the root length, initially, and estimated radiographic alveolar bone gain was 4.0 ± 2.2 mm ultimately, in 17 replanted teeth with SOT. Only one tooth (5.9%) exhibited root resorption. Ankylosis was not observed during the study. Periapical radiographs demonstrated that satisfactory periodontal healing of lamina dura and bone fills occurred in all replanted teeth with SOT. Generally, tooth mobility and SOT were significantly improved after therapy. Most treated teeth functioned well and remained stable clinically throughout the periods of study. The present study documented a promising outcome for autogenous IR and periprosthetic therapy of 17 periodontally hopeless teeth for 5-12 years. The present study revealed good bone gain and elimination of SOT and prominent occlusal function. We concluded that the application of IR, minocycline-HCL and periodontal prosthetic procedures later elevated the prognosis of these otherwise hopeless teeth with SOT, which are valuable options for retaining teeth with periodontally extreme situations.
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Affiliation(s)
- Guey‐Lin Hou
- Graduate Institute of Dental Science, Department of Periodontal Prosthesis, College of Oral MedicineKaohsiung Medical UniversityKaohsiungTaiwan
| | - Lein‐Tuan Hou
- Graduate Institute of Dental Science, Department of Periodontics, School of DentistryNational Taiwan UniversityTaipeiTaiwan
| | - Arnold Weisgold
- Graduate Institute of Periodontal Prosthetics, School of Dental MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
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Ryana HK, Srinath R, Prakash S. Surgical Re-entry of an Intentionally Replanted Periodontally Compromised Tooth Treated with Platelet Rich Fibrin (PRF): Hopeless to Hopeful. J Clin Diagn Res 2016; 10:ZD01-4. [PMID: 27504421 DOI: 10.7860/jcdr/2016/19245.7945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/13/2016] [Indexed: 11/24/2022]
Abstract
Intentional replantation is generally contraindicated in periodontally compromised teeth however, there are reports suggesting that it can be a successful treatment alternative for periodontally involved hopeless teeth. Currently there is dearth of evidence regarding the success of this therapy, especially evidence for the effectiveness of autologous platelet rich fibrin is lacking. We present a case report of a 23-year-old male patient with periodontally hopeless left maxillary central incisor having bone loss extending beyond root apex. The tooth was gently extracted and replanted utilizing root conditioning and combined regenerative therapy (Xenograft, PRF and Type I Collagen Membrane). Surgical re-entry at nine months revealed bone formation in the apical third of the tooth. At one year, 87% radiographic bone gain was accomplished. The improvement in the clinical and radiographic parameters reinforced by the re-entry surgery findings strongly suggest that intentional replantation may be a cost-effective substitute to implants and tooth supported prosthesis in situations where conventional periodontal therapy would yield compromised outcomes.
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Affiliation(s)
- Haneet Kour Ryana
- Assistant Editor, Journal of Clinical and Diagnostic Research , Delhi, India
| | - Rashmi Srinath
- Reader, Department of Periodontics, College of Dental Sciences , Davangere, Karnataka, India
| | - Shobha Prakash
- Head of Department, Department of Periodontics, College of Dental Sciences , Davangere, Karnataka, India
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Keceli HG, Hendek MK. Fifteen months follow-up of a hopeless tooth treated with two-step procedure involving intentional replantation and free gingival graft. Eur J Dent 2014; 8:559-562. [PMID: 25512741 PMCID: PMC4253116 DOI: 10.4103/1305-7456.143644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the report is to document 15-month results of mucogingival surgery applied following intentional replantation (IntR). A mandibular left lateral incisor with severe periodontitis and malposition was replanted and splinted following root canal treatment. Three months after IntR, a free gingival graft (FGG) was placed. Fifteen months follow-up of the case demonstrated significant improvement in periodontal healing parameters and significant bone fill was detected around the root apex. As a conclusion, IntR may be speculated as a convenient alternative to keep the periodontally hopeless teeth and supportive approaches such as FGGs may improve the outcomes following IntR.
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Affiliation(s)
- Huseyin Gencay Keceli
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkiye
| | - Meltem Karsiyaka Hendek
- Department of Periodontology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkiye
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16
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Lee EU, Lim HC, Lee JS, Jung UW, Kim US, Lee SJ, Choi SH. Delayed intentional replantation of periodontally hopeless teeth: a retrospective study. J Periodontal Implant Sci 2014; 44:13-9. [PMID: 24616829 PMCID: PMC3945391 DOI: 10.5051/jpis.2014.44.1.13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/06/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Eun-Ung Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Sung Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Seung-Jong Lee
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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17
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Patel GK, Gujjari SK, Annapoorna BM, Veerendra Kumar SC. Management of chronic luxated central incisor with hopeless prognosis. J Indian Soc Periodontol 2013; 17:670-5. [PMID: 24174766 PMCID: PMC3808027 DOI: 10.4103/0972-124x.119292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 08/25/2013] [Indexed: 11/04/2022] Open
Abstract
Traumatic injuries are the most studied yet most challenging for a dentist. Extrusive luxation injuries are usually managed by repositioning tooth in the original position and pulp sensibility is evaluated at regular periodic intervals. However, when injuries are chronic, tooth is necrotic with compromised periodontal support, treatment is a challenge. Intentional replantation utilizing growth factors in fibrin rich network of platelet rich fibrin can be a treatment modality in such patients where other restorative modalities to establish function-esthetics rehabilitation is not possible.
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Affiliation(s)
- Gauresh Kumar Patel
- Department of Periodontology, JSS Dental College and Hospital, Mysore, Karnataka, India
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18
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Nagappa G, Aspalli S, Devanoorkar A, Shetty S, Parab P. Intentional replantation of periodontally compromised hopeless tooth. J Indian Soc Periodontol 2013; 17:665-9. [PMID: 24174765 PMCID: PMC3808026 DOI: 10.4103/0972-124x.119291] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 08/29/2013] [Indexed: 11/04/2022] Open
Abstract
Aesthetic considerations have influenced the management of dental maladies in varying degrees for many years. Even single tooth mal-alignment makes the patient to approach a dentist. Intentional replantation is a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth. Many authors agree that it should be reserved as the last resort to save a tooth after other procedures have failed or would likely to fail. The main reason of failure in replanted teeth is root resorption, specifically ankylosis or replacement resorption. Although the success rate is not always high, intentional replantation may be a treatment alternative that deserves consideration to maintain the natural dentition and avoid extraction of the tooth. Here is case report of a patient desiring alignment of malpositioned periodontally involved anterior single tooth due to various causes treated by intentional replantation.
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Affiliation(s)
- G Nagappa
- Department of Periodontics and Oral Implantology, A.M.E's Dental College and Hospital, Raichur, Karnataka, India
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19
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Kim DJ, Cha JK, Yang C, Cho A, Lee JS, Jung UW, Kim CS, Lee SJ, Choi SH. Changes in periodontium after extraction of a periodontally-involved tooth in rats. J Periodontal Implant Sci 2012. [PMID: 23185696 PMCID: PMC3498300 DOI: 10.5051/jpis.2012.42.5.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose Recent interest has focused on intentional replantation to restore an original tooth. Some studies have shown successful results with intentional replantation for periodontally involved teeth. For long-term success of replantation, a healthy periodontal status of the recipient site is required so that delayed replantation is more suitable for periodontally involved teeth. To reveal the ideal timing for delayed replantation of periodontally involved teeth, the healing process of extraction sockets after extraction of periodontitis-induced teeth in rats was evaluated. Methods Twenty-eight rats were randomly divided into two groups: a control group (n=8) and test group (n=20). In the test group, periodontitis was induced by a ligature around the cervix of the mandibular first molar of all of the rats. Two weeks later, the mandibular first molars were extracted in all of the animals. The animals were sacrificed on days 0, 3, 7, and 10 after extraction and histological and immunohistochemical analysis was performed. Results In histological analysis of the test group, inflammatory cell infiltrate was found abundantly in the remaining periodontium 3 days after tooth extraction and decreased gradually at later time points. In immunohistochemical analysis of the test group, both interleukin-6 (IL-6) and, tumor necrosis factor-α (TNF-α) were numerous in the furcation area at each postextraction day. IL-6 was stained more heavily between 3 and 7 days after extraction; at day 10 after extraction, little staining was observed. TNF-α staining was more intense at 3 days after extraction and gradually weakened at later points in time. Conclusions Within the limits of this study, it takes at least 10 days to resolve periodontal inflammation in rat extraction sockets.
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Affiliation(s)
- Dong-Ju Kim
- Department of Periodontology, Yonsei University College of Dentistry, Seoul, Korea
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20
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Rouhani A, Javidi B, Habibi M, Jafarzadeh H. Intentional replantation: a procedure as a last resort. J Contemp Dent Pract 2011; 12:486-492. [PMID: 22269241 DOI: 10.5005/jp-journals-10024-1081] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To address the indications, contraindications, surgical procedure, complications following treatment, factors influencing the results and success rate of intentional replantation procedure. BACKGROUND Intentional replantation is extraction of a tooth to do extraoral root canal therapy, curettage of apical lesion when present, and its replacement in its socket. It has been proposed as an alternative to routine extraction; however, it should be considered a last resort because the root may be fractured during extraction. RESULTS The success rate of intentional replantation is far below than routine endodontic treatment or apical surgery. Difficultness of tooth extraction, the possibility of fracture during extraction and the risk of external resorption are some limitations of this treatment. The most common causes of failure in intentionally replanted teeth are external inflammatory resorption or replacement resorption and ankylosis caused by periodontal ligament damage. CONCLUSION The success rate up to 95% with an average retention of 3 to 5 years, has been reported. CLINICAL SIGNIFICANCE In some cases, endodontic retreatment or apical surgery is impossible or impractical. In these situations, intentional replantation may be considered as a last resort for preserving the tooth, so all clinicians should know about its indications/contraindications, surgical procedure and complications following treatment.
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Affiliation(s)
- Armita Rouhani
- Department of Endodontics, Faculty of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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21
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Ekuni D, Yamamoto T, Takeuchi N. Retrospective study of teeth with a poor prognosis following non-surgical periodontal treatment. J Clin Periodontol 2009; 36:343-8. [DOI: 10.1111/j.1600-051x.2009.01373.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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22
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Demir B, Demiralp B, Güncü GN, Uyanik MO, Cağlayan F. Intentional replantation of a hopeless tooth with the combination of platelet rich plasma, bioactive glass graft material and non-resorbable membrane: a case report. Dent Traumatol 2007; 23:190-4. [PMID: 17511843 DOI: 10.1111/j.1600-9657.2005.00414.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Intentional replantation can be an alternative choice for periodontally involved hopeless tooth at least for a period of time. This technique may help to restore an original tooth to function in the mouth instead of replacing it with prosthesis. The combination of one or more techniques currently available for periodontal therapy may have the potential to enhance clinical results as compared to any of the techniques used alone. In this case report, intentional replantation was combined with regenerative techniques. A very popular agent, platelet rich plasma was used in combination with bioactive glass graft material and non-resorbable PTFE membrane. The technique and one year results of treatment were discussed radiographically and clinically.
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Affiliation(s)
- Becen Demir
- Department of Periodontology, Hacettepe University, Ankara, Turkey
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23
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Tözüm TF, Keçeli HG, Serper A, Tuncel B. Intentional replantation for a periodontally involved hopeless incisor by using autologous platelet-rich plasma. ACTA ACUST UNITED AC 2006; 101:e119-24. [PMID: 16731375 DOI: 10.1016/j.tripleo.2005.10.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2005] [Revised: 02/12/2005] [Accepted: 10/17/2005] [Indexed: 11/24/2022]
Abstract
The aim of the present case is to describe the use of autologous platelet-rich plasma (PRP) in an intentional replantation procedure for a periodontally involved lower right central incisor with 18 months follow-up. Brief information is also given on the preoperative preparation of PRP in the dental office. PRP preparation is a new biotechnology, and the prepared material contains thrombocyte concentrates and high levels of growth factors. This material promotes healing time in a range of various sites. In this case, a tooth with severe periodontal breakdown was treated with PRP with intentional replantation procedure. This tooth was previously treated with root canal treatment and root planing. The tooth was extracted, and was replanted with autologous PRP. Clinical and radiographic follow-up for 18 months demonstrated new bone formation around the apical portion of the root and all clinical parameters indicated a trend of healing. The mobility of this previously grade III mobile incisor returned to normal limits. We speculate that intentional replantation with PRP application may induce wound healing and may induce bone formation.
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Affiliation(s)
- Tolga Fikret Tözüm
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, Turkey.
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25
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COHN STEVENA. Treatment choices for negative outcomes with non-surgical root canal treatment: non-surgical retreatment vs. surgical retreatment vs. implants. ACTA ACUST UNITED AC 2005. [DOI: 10.1111/j.1601-1546.2005.00163.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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