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Luo Y, Li J, Liu L, Ye L, Song D, Huang D. Comparison of the Outcome of Intentional Replantation in Teeth with or without Periodontal Involvement: A Retrospective Study. J Endod 2024:S0099-2399(24)00225-5. [PMID: 38588976 DOI: 10.1016/j.joen.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Intentional replantation (IR) is considered as a viable treatment option to preserve the teeth with apical periodontitis. This study aimed to compare the treatment outcomes of IR in teeth with or without periodontal involvement, and to investigate the influence of related factors. METHODS A total of 157 teeth with a documented history of IR between September 2012 and November 2022 and a follow-up duration of more than 1 year were included. The samples included 100 teeth with simple apical periodontitis and 57 teeth with combined periodontal-endodontic lesions (CPEL). Clinical and radiographic criteria were used to evaluate treatment outcomes including functional retention and extraction. Chi-square analyses and Fisher's exact tests were used to compare bivariate associations between outcomes and clinical or demographic variables. Kaplan-Meier analyses were used to evaluate the cumulative survival rate of the intentionally replanted teeth. RESULTS The overall cumulative survival rates were 93.0% at 1 year, 76.7% at 5 years, and 56.2% at 10 years. Among the 100 teeth with simple apical periodontitis, the survival rates were 93.0%, 86.7%, and 78.8% at the same time points. In contrast, 57 teeth with CPEL exhibited survival rates of 93.0%, 65.0%, and 36.9%, respectively. The primary postoperative complications that led to extraction were periodontal involvement (51.9%), tooth fracture (18.5%), external root resorption (18.5%), and persistent apical periodontitis (11.1%). The outcomes of teeth with CPEL were significantly affected by the presence of a sinus tract and crown restoration. In contrast, no significant prognostic factors were identified for teeth without periodontal involvement. CONCLUSION The long-term prognosis of teeth with CPEL is significantly worse than those with simple apical periodontitis. The main reason of extraction was periodontal involvement. Regular periodontal maintenance and appropriate crown restoration may help to improve the prognosis for teeth with CPEL.
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Affiliation(s)
- Yu Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiatong Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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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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Javed F, Zafar K, Khan FR. Outcome of intentional replantation of endodontically treated teeth with periapical pathosis: A systematic review and meta-analysis. AUST ENDOD J 2023; 49 Suppl 1:494-507. [PMID: 36354086 DOI: 10.1111/aej.12707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 08/02/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022]
Abstract
The purpose of the present review was to examine success, survival and failure following intentional replantation of endodontically treated teeth with existing periapical pathosis and to determine the factors that might affect the outcome of replantation. Clinical trials, longitudinal studies, case series with >10 cases and at least 1-year follow-up were included. The average rate of success following intentional replantation was 77.23%. Meta-analysis revealed the mean weighted survival to be 85.9% (95% CI: 79.6-91.2) Common complications include inflammatory root resorption (0%-27%) and ankylosis (0%-25%). Variables influencing successful outcome include extra alveolar dry time <15 min; root-end resection (2-3 mm) and cavity preparation (3 mm); manipulation of the tooth using the crown only; and use of an appropriate storage media. The review concludes that intentional replantation is a viable treatment option with acceptable survival rates for endodontically treated teeth with periapical pathosis.
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Affiliation(s)
- Faizan Javed
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
| | - Kamil Zafar
- Endodontics, Baqai Dental College, Karachi, Pakistan
| | - Farhan R Khan
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
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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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Intentional Replantation as a Starting Approach for a Multidisciplinary Treatment of a Mandibular Second Molar: A Case Report. J Clin Med 2022; 11:jcm11175111. [PMID: 36079036 PMCID: PMC9457313 DOI: 10.3390/jcm11175111] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/28/2022] [Accepted: 08/28/2022] [Indexed: 11/17/2022] Open
Abstract
Intentional replantation (IR) may offer a solution for persistent periapical lesions associated with endodontically treated teeth. A 35-year-old male patient presented with pain associated with the left mandibular second molar and hypoesthesia. Upon clinical examination, increased probing pocket depth in the mid-buccal surface was detected. Cone beam computed tomography revealed a previous non-surgical root canal treatment, with root canal filling material extrusion adjacent to the inferior alveolar nerve, a fractured instrument in the mesial root, and a large periapical radiolucency involving both teeth 37 and 36. A diagnosis of symptomatic post-treatment apical periodontitis was established. After discussing treatment options with the patient, an IR of tooth 37 was performed. Extra-oral procedures were completed in 17 min. At 9 months, hypoesthesia resolution was reported, and apical healing was radiographically observed. After 2.5 years, the replanted tooth showed extensive root resorption. An extraction with alveolar ridge preservation, using leukocyte-platelet rich fibrin (L-PRF), was performed. Six months after tooth extraction and regeneration, implant placement surgery was carried out. IR presents a valid treatment modality for the management of post-treatment apical periodontitis. When orthograde retreatment or apical microsurgery prove to be unfeasible, IR is a unique procedure with the potential to promote tooth preservation in properly selected cases. Although unsuccessful after 2.5 years, the IR of tooth 37 allowed for bone regeneration, the maintenance of tooth 36 vitality, and hypoesthesia resolution.
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Tan D, Li ST, Feng H, Wang ZC, Wen C, Nie MH. Intentional replantation combined root resection therapy for the treatment of type III radicular groove with two roots: A case report. World J Clin Cases 2022; 10:6991-6998. [PMID: 36051153 PMCID: PMC9297402 DOI: 10.12998/wjcc.v10.i20.6991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/29/2022] [Accepted: 05/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A radicular groove is an anatomic malformation that usually initiates at the central fossa, extending along the root at varying lengths and depths and predisposes the involved tooth to a severe periodontal defect. Severe grooves that extend to the root apex often lead to complex combined periodontal-endodontic lesions. They are a serious challenge for doctors to diagnose and treat.
CASE SUMMARY In this report, we described a patient with a maxillary lateral incisor with a deep palatogingival groove with two roots, which led to complex combined periodontal-endodontic lesions. Suggested treatment modalities included curettage of the affected tissues, elimination of the groove by grinding and/or sealing with a variety of filling materials, and surgical procedures. In this case, a combination of endodontic therapy, intentional replantation, and root resection were used, which resulted in periodontal/periradicular healing after 12 mo.
CONCLUSION Intentional replantation and root resection offer a predictable procedure and should be considered a viable treatment modality for the management of palatogingival grooves, especially for two-rooted teeth.
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Affiliation(s)
- Dan Tan
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Shi-Ting Li
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Hao Feng
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Zhong-Chao Wang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Cai Wen
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Min-Hai Nie
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Zhang J, Li N, Li WL, Zheng XY, Li S. Management of type IIIb dens invaginatus using a combination of root canal treatment, intentional replantation, and surgical therapy: A case report. World J Clin Cases 2022; 10:6261-6268. [PMID: 35949847 PMCID: PMC9254211 DOI: 10.12998/wjcc.v10.i18.6261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/08/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type Ⅲb dens invaginatus (DI) with a lateral canal located at the mid-third of the root is rarely reported. Here, we report a rare case of type Ⅲb DI in the left upper anterior tooth with a lateral canal that led to persistent periodontitis.
CASE SUMMARY A 15-year-old female patient presented with a chief complaint of pain associated with recurrent labial swelling in the area of the left anterior tooth. A diagnosis of type Ⅲb DI and chronic periodontitis was made. Intentional replantation was performed after conventional endodontic treatment failed. After 6 mo, the patient was asymptomatic, but a sinus tract was observed. Cone-beam computed tomography images showed bone loss in the mesial of the mid-root. Based on methylene blue staining and microscopy images, the lateral foramen located at the middle third of the root was surgically treated. After 3 years of follow-up, the clinical findings and radiographic assessment presented a favorable prognosis of bone healing without root absorption or ankylosis.
CONCLUSION Type Ⅲb DI with a lateral canal can be successfully treated by root canal treatment, intentional replantation, and surgical therapy.
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Affiliation(s)
- Jing Zhang
- Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Na Li
- Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Wu-Li Li
- Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Xian-Yu Zheng
- Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Song Li
- Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China
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Yu YH, Kim M, Kratchman S, Karabucak B. Surgical management of lateral lesions with intentional replantation in single-rooted mandibular first premolars with radicular groove. J Am Dent Assoc 2022; 153:371-381. [DOI: 10.1016/j.adaj.2021.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
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Chaniotis A, Kouimtzis TH. Intentional replantation and Biodentine root reconstruction. A case report with 10-year follow-up. Int Endod J 2021; 54:988-1000. [PMID: 33421151 DOI: 10.1111/iej.13475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/26/2022]
Abstract
AIM To describe the innovative use of intentional replantation for Biodentine root reconstruction of a previously treated immature maxillary central incisor with vertically extended crown root fracture and root detachment. SUMMARY In the present case, the intentional replantation of a failing, previously treated maxillary central incisor with a vertical crown/root fracture in a 12-year-old male patient is reported. The gross extrusion of gutta-percha points beyond the apex and the pre-existing extensive, trauma related, distal cervical dentinal detachment justified the intentional replantation treatment plan as an option for tooth retention. After controlling the infection by oral administration of antibiotics, the immature tooth was extracted atraumatically and kept in gauze embedded with tooth replantation medium. The apical third of the immature fractured tooth was treated with ultrasonics and an MTA plug (MTA Angelus White, Londrina, Brazil). The distal cervical dentinal root defect was reconstructed with Biodentine (Septodont, St. Maur-des-Fosses, France). The tooth was reinserted and stabilized to the adjacent teeth for 2 weeks. The total extraoral time before replantation was 25 min. In the 10 years since the initial trauma (9 years after the intervention) radiographic and clinical evaluation revealed uneventful healing of the periapical lesion, normal mobility and no detectable signs of external replacement resorption. KEY LEARNING POINTS Intentional replantation may provide a viable treatment alternative in cases of severe complicated crown/ root fractures Biodentine may be useful in the reconstruction of external root defects in crown root fractured traumatic dental injuries.
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Affiliation(s)
- A Chaniotis
- Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - T H Kouimtzis
- Dental School, National and Kapodistrian University of Athens, Athens, Greece.,Faculté de Chirurgie Dentaire, Université Rene Decartes, Paris, France
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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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Fujii R, Morinaga K, Asai T, Aida N, Yamada M, Sako R, Furusawa M. Intentional Replantation to Treat Apical Periodontitis of Maxillary First Molar with Foreign Body Located Outside Apical Foramen Using CBCT: A Case Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2020; 61:127-133. [PMID: 32507779 DOI: 10.2209/tdcpublication.2019-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The recent use of cone beam computed tomography (CBCT) in the field of dentistry to obtain 3-dimensional (3D) images has enabled more effective examination and diagnosis in endodontic treatment. Such information has also been reported to be of benefit in surgical endodontic treatment such as intentional replantation. Here, we report a case of intentional replantation with the assistance of CBCT in which a good therapeutic outcome was achieved. The patient was a 30-year-old woman who visited our hospital with the chief complaint of spontaneous pain in the right maxillary first molar. Dental radiographs revealed a radiolucent area in the apical portion of the distal root, and a radiopaque area thought to be a broken shard from a small surgical instrument measuring approximately 1.5 mm in length. The shard was located outside the distal apical foramen. Based on these findings, the diagnosis was acute suppurative apical periodontitis of the right maxillary first molar. Infected root canal therapy was subsequently commenced. The patient's symptoms showed no improvement, however, and the pain persisted. Therefore, dental CBCT was performed to obtain 3D images, which confirmed a radiopaque area thought to be a broken shard from a small surgical instrument located outside the apical foramen of the distal root and facing in a direction that made it impossible to remove from the root canal. Because the patient's symptoms had shown no improvement and a foreign body was observed outside the apical foramen, intentional replantation combined with root resection was performed with informed consent. At a 1-year follow-up visit, progress was good, and there were no reported symptoms or signs. When reaching a diagnosis is difficult based on clinical findings and dental radiographs alone, the 3D images provided by CBCT offer a means of securing a more reliable diagnosis, allowing planning of treatment to be more effective.
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Affiliation(s)
- Rie Fujii
- Department of Endodontics, Tokyo Dental College
| | | | - Tomohiro Asai
- Department of Endodontics, Tokyo Dental College.,Department of Endodontics, Tokyo Dental College
| | | | | | - Ryo Sako
- Department of Endodontics, Tokyo Dental College
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Mokhtari S, Hajian S, Sanati I. Complicated Crown-root Fracture Management Using the 180-degree Rotation Method. Int J Clin Pediatr Dent 2019; 12:247-250. [PMID: 31708624 PMCID: PMC6811941 DOI: 10.5005/jp-journals-10005-1625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim The aim of this article is to report a successful treatment of a complicated crown-root fracture. Background The management of complicated crown-root fracture in young patients is challenging as the fracture line is below the bone crest and the pulp is exposed. Treatment options include crown lengthening, orthodontic extrusion, and intentional replantation. Case description Here, a case of complicated crown-root fracture of tooth number 11 in a ten-year-old boy is presented. Intentional replantation with 180° rotation and slight extrusion and fixation was performed. In addition, root canal therapy was done and tooth was restored with a composite resin after four weeks. The patient was asymptomatic clinically and radiographically after three-year follow-up. Conclusion Intentional replantation with 180° rotation is a valuable treatment for crown root fractures. Clinical significance The management of complicated crown-root fracture using intentional replantation with 180° rotation can help to maintain natural dentition and interdental papilla. How to cite this article Mokhtari S, Hajian S, et al. Complicated Crown-root Fracture Management Using the 180-degree Rotation Method. Int J Clin Pediatr Dent 2019;12(3):247-250.
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Affiliation(s)
- Saeedeh Mokhtari
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Iman Sanati
- Department of Pedodontics, Private Practice, Tehran, Iran
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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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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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16
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Intentional Replantation Techniques: A Critical Review. J Endod 2018; 44:14-21. [DOI: 10.1016/j.joen.2017.08.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/30/2017] [Accepted: 08/02/2017] [Indexed: 12/21/2022]
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17
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Grzanich D, Rizzo G, Silva RM. Saving Natural Teeth: Intentional Replantation—Protocol and Case Series. J Endod 2017; 43:2119-2124. [DOI: 10.1016/j.joen.2017.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/26/2017] [Accepted: 08/03/2017] [Indexed: 10/18/2022]
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A Systematic Review of the Survival of Teeth Intentionally Replanted with a Modern Technique and Cost-effectiveness Compared with Single-tooth Implants. J Endod 2017; 43:1963-1968. [DOI: 10.1016/j.joen.2017.08.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 06/28/2017] [Accepted: 08/13/2017] [Indexed: 12/18/2022]
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Influence of Cone-beam Computed Tomography on Endodontic Retreatment Strategies among General Dental Practitioners and Endodontists. J Endod 2017; 43:1433-1437. [DOI: 10.1016/j.joen.2017.04.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 03/27/2017] [Accepted: 04/02/2017] [Indexed: 12/16/2022]
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Xuelian T, Lan Z, Dingming H. [Intentional replantation for the treatment of palatal radicular groove with endo-periodontal lesion in the maxillary lateral incisor: a case report]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:448-452. [PMID: 28853516 DOI: 10.7518/hxkq.2017.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Palatal radicular groove leads to severe endo-periodontal lesion in lateral incisors. The groove occurs on the labial and lingual root surfaces, while the localized periodontal pocket develops along the lingual groove length. The complicated root canal system, extensively destroyed bone lamella, and persistent fistula pose a challenge for root canal therapy, tooth retention, and thorough infection control inside and outside of the root canal. Combining microscopic root canal therapy with intentional replantation and nano-biomaterial application facilitates infection control, tooth retention, and formation of newly periodontal attachment.
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Affiliation(s)
- Tan Xuelian
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospitalof Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhang Lan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospitalof Stomatology, Sichuan University, Chengdu 610041, China
| | - Huang Dingming
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospitalof Stomatology, Sichuan University, Chengdu 610041, China
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Cho SY, Lee SJ, Kim E. Clinical Outcomes after Intentional Replantation of Periodontally Involved Teeth. J Endod 2017; 43:550-555. [DOI: 10.1016/j.joen.2016.11.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/09/2016] [Accepted: 11/24/2016] [Indexed: 01/01/2023]
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22
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Tan X, Zhang L, Zhou W, Li Y, Ning J, Chen X, Song D, Zhou X, Huang D. Palatal Radicular Groove Morphology of the Maxillary Incisors: A Case Series Report. J Endod 2017; 43:827-833. [PMID: 28343927 DOI: 10.1016/j.joen.2016.12.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/21/2016] [Accepted: 12/28/2016] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Teeth with a palatal radicular groove are challenging to diagnose, treat, and save. We classified this condition using cone-beam computed tomographic (CBCT) cross-sectional configurations combined with radiographic and morphologic observations during an intentional replantation procedure to identify and analyze the characteristics of palatal radicular grooves comprehensively as a reference for diagnosis, treatment planning, and prognosis evaluation of this condition. METHODS Eight cases with palatal radicular grooves present in permanent maxillary incisors were investigated by radiography and CBCT imaging before intentional replantation. RESULTS The palatal radicular grooves were classified into 3 types based on groove depth and cross-sectional shape on CBCT images: type I, with a shallow groove depth, corresponding to a normal, simple, and single root canal; type II, with a medium groove depth, corresponding to a C-shaped canal system; and type III, with a deep groove depth, almost bisecting the root of the tooth, simultaneously present with 2 independent root canals and an apex with normal shape, corresponding to a labial groove connecting with a palatal groove. The extracted teeth and their radiographic images showed corresponding characteristics. CONCLUSIONS The CBCT cross-sectional images allowed the best visualization of the depth of the grooves and highlighted the difficulties entailed in treating such teeth. Intentional replantation is an effective therapeutic decision for this type of deformity and can provide better prognosis estimation, especially in teeth with type II and III grooves.
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Affiliation(s)
- Xuelian Tan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Wei Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiali Ning
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xi Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Cho SY, Lee Y, Shin SJ, Kim E, Jung IY, Friedman S, Lee SJ. Retention and Healing Outcomes after Intentional Replantation. J Endod 2016; 42:909-15. [DOI: 10.1016/j.joen.2016.03.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/08/2016] [Accepted: 03/08/2016] [Indexed: 01/30/2023]
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Garrido I, Abella F, Ordinola-Zapata R, Duran-Sindreu F, Roig M. Combined Endodontic Therapy and Intentional Replantation for the Treatment of Palatogingival Groove. J Endod 2016; 42:324-8. [DOI: 10.1016/j.joen.2015.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 10/05/2015] [Accepted: 10/17/2015] [Indexed: 02/08/2023]
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25
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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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Elkhadem A, Mickan S, Richards D. Adverse events of surgical extrusion in treatment for crown-root and cervical root fractures: a systematic review of case series/reports. Dent Traumatol 2013; 30:1-14. [DOI: 10.1111/edt.12051] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Ahmed Elkhadem
- Pediatric Dentistry Department; Faculty of Oral and Dental Medicine; Cairo University; Cairo Egypt
| | - Sharon Mickan
- Department of Primary Health Care; International Program in Evidence Based Health Care; University of Oxford; Oxford UK
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27
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Lee W, Shon WJ, Baek SH, Kum KY, Kim HC. Outcomes of intentionally replanted molars according to preoperative locations of periapical lesions and the teeth. J Dent Sci 2012. [DOI: 10.1016/j.jds.2012.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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28
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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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29
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Choi YH, Bae JH. Clinical evaluation of a new extraction method for intentional replantation. ACTA ACUST UNITED AC 2011. [DOI: 10.5395/jkacd.2011.36.3.211] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Yong-Hoon Choi
- Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji-Hyun Bae
- Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
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30
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Sivolella S, Bressan E, Mirabal V, Stellini E, Berengo M. Extraoral endodontic treatment, odontotomy and intentional replantation of a double maxillary lateral permanent incisor: case report and 6-year follow-up. Int Endod J 2008; 41:538-46. [PMID: 18363700 DOI: 10.1111/j.1365-2591.2008.01391.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To describe combined endodontic, surgical and orthodontic treatment of a maxillary lateral incisor fused with a supernumerary. SUMMARY Double tooth is a dental irregularity consequent to fusion of two or more teeth or dental gemination. The teeth most commonly involved are deciduous, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, functional and periodontal problems can result. This paper reports a clinical case of a double tooth in the position of the maxillary right lateral permanent incisor. Combined orthodontic, endodontic and surgical treatment (intentional replantation) allowed the tooth to be retained without periodontal compromise and with a positive orthodontic result both immediately and 6 years following intervention. *A conservative approach that addresses periodontal, pulpal and tooth tissues, can result in the retention of a double tooth. *Maintenance of the root and alveolar bone in young adults at least until full skeletal maturation should be the main treatment objective.
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Affiliation(s)
- S Sivolella
- Department of Oral Surgery, University of Padova, Institute of Clinical Dentistry, Padova, Italy.
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31
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Martins WD, Westphalen VPD, Perin CP, Da Silva Neto UX, Westphalen FH. Treatment of extrusive luxation by intentional replantation. Int J Paediatr Dent 2007; 17:134-8. [PMID: 17263865 DOI: 10.1111/j.1365-263x.2006.00798.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The accepted treatment for extrusive luxation is repositioning of the extruded tooth at the earliest possible opportunity. CASE REPORT Repositioning was not possible in a patient who presented for treatment 4 days after the accident, and therefore, an intentional replantation was performed instead. The tooth was carefully extracted, the blood clot removed from the alveolus and the tooth was then replanted. CONCLUSION Intentional replantation involves the deliberate removal of a tooth and its reinsertion into the alveolus almost immediately afterwards. It is now an accepted endodontic procedure. The favourable outcome of this case suggests that intentional replantation of severely extruded teeth may be a treatment option in cases where the tooth cannot be repositioned and if treatment conditions are adequately followed.
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Herrera H, Leonardo MR, Herrera H, Miralda L, Bezerra da Silva RA. Intentional replantation of a mandibular molar: case report and 14-year follow-up. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2006; 102:e85-7. [PMID: 16997101 DOI: 10.1016/j.tripleo.2006.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Accepted: 02/03/2006] [Indexed: 05/11/2023]
Abstract
This case report describes the nonsurgical endodontic treatment and intentional replantation of a mandibular molar and its nearly 14-year follow-up. A 56-year-old woman sought treatment with complaint of discomfort and sensitivity in the mandibular left area. The radiographic examination showed that the mandibular left first molar was endodontically treated, with over-instrumentation of the distal root and unsatisfactory obturation on the mesial root. A large periapical lesion was observed surrounding the roots. In view of the patient's limited interocclusal space and objection to undergo an apical surgery, intentional replantation was suggested as an alternative. The patient returned for clinical and radiographic follow-up at 15 days, 40 days, 6 months, 12 months, and once yearly thereafter. At the last visit, after 14 years, no painful symptomatology was reported, probing depth was no greater than 3 mm, the periradicular area had normal appearance and no evidence of root resorption or periapical lesion.
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Affiliation(s)
- Henry Herrera
- Evangelic University of El Salvador, El Salvador, Brazil
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