Effect of masticatory stimulation on dentoalveolar ankylosis after experimental tooth replantation

Abstract

Dentoalveolar ankylosis (replacement resorption) is a serious complication after replantation of avulsed teeth. The purpose of the present study was to investigate the influence of masticatory stimulation on dentoalveolar ankylosis after replantation of avulsed teeth. Monkey upper incisors were extracted, air‐dried for 1 h, endodontically treated and replanted. No splinting was used. One group of monkeys was given hard pelleted food, while another group was given soft diet during a healing period of 8 wk. The periodontal conditions were evaluated histologically with a morphometrical method. The replanted teeth of the monkeys given the hard pelleted food had significantly less ankylosis and a larger area of the root surrounded by a normal periodontal membrane than the teeth from the monkeys given a soft diet. In conclusion, development of ankylosis seemed to be partially prevented or reduced by masticatory stimulation.

Tooth splinting: a review of the literature and consideration of the versatility of a wire‐composite splint

“…It has been confirmed in animal experiments that normal masticatory stimulation can prevent and eliminate small external resorption areas on the root suiiace (20), even though extended masticatory stimulation does not prevent dentoalveolar ankylosis in teeth replanted with extended extra-oral periods but rather alter its pattern (21). If the extraalveolar period is less than 20 tnin there is a marked increase in the incidence of external replacement root resoprtion in teeth that are splinted as compared with those that are not, most of the teeth being resorbed regardless of splinting if the extraalveolar period is over 2 h (18), thus indicating that the most decisive factor in the development of ankylosis is the extra-alveolar time (5).…”

“…Its flexibility has been tested on a model, and mobility tests performed in clinical situations with the Periotest device (Siemens, BRD) show similar results (material in preparation). The advantages of flexible splinting have not been investigated experimentally, but it can be concluded from various animal studies that normal masticatory stimulus prevents and eliminates small resorption areas (4,20) and promotes pulpal healing (42). Splinting with a flexible wire-composite splint focuses the occlusal forces on the teeth in an almost normal manner.…”

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth

“…Splinting of replanted teeth (77)(78)(79)(80)(81)(82)(83) It is considered best practice to maintain the repositioned tooth in correct position, provide patient comfort and improve function. Current evidence supports short-term, flexible splints for splinting of replanted teeth.…”

Outcomes of intentionally replanted molars according to preoperative locations of periapical lesions and the teeth

“…7 However, splinting is not usually recommended and is still controversial because rigid splinting may cause ankylosis of the replanted tooth. 25,26 Considering this tendency, teeth in this study were not splinted as a standardized protocol by the operators, but this could have potentially increased the mobility of the replanted maxillary molars after IR. Thus, maxillary posterior teeth may need a splint after IR to improve treatment outcomes.…”