Replantation of 400 avulsed permanent incisors. 1. Diagnosis of healing complications

Abstract

A material of 322 patients with 400 avulsed and replanted permanent teeth were followed prospectively in the period from 1965 to 1988 (mean observation period = 5.1 yrs). The age of the patients at the time of replantation ranged from 5 to 52 yrs (mean = 13.7 yrs and median = 11.0 yrs). Standardized patient records were used through the entire period in order to obtain valid data concerning the extent of injury and treatment provided. At the follow-up period, pulpal and periodontal healing were monitored by clinical examination, mobility testing and standardized radiographic controls. Thirty-two of the replanted teeth (8%) showed pulpal healing. When related to teeth with incomplete root formation, where pulpal revascularization was anticipated (n = 94) the frequency of pulpal healing was 34%. Periodontal ligament healing (i.e. with no evidence of external root resorption) was found in 96 teeth (24%). Gingival healing was found in 371 teeth (93%). During the observation period, 119 teeth (30%) were extracted. Tooth loss was slightly more frequent in teeth with incomplete root formation at the time of replantation than in teeth with completed root formation.

Effect of basic fibroblast growth factor on root resorption after delayed autotransplantation of tooth in dogs

“…[1][2][3][4] When treated with adequate indications, autotransplantation offers a fast and economically viable option for replacing missing teeth 2,[5][6][7] Root resorption, the most common complication accompanying autotransplantation, leads to poor esthetics, the tilting of adjacent teeth, loss of function, and permanent tooth loss. [8][9][10] Occurrence of replacement resorption is influenced by factors such as the extra-alveolar period 11 , preservative solution 12 , pulpal revascularization 13 , and microbial contamination. 14 Treatment, often complex, time-consuming, and expensive, requires a multidisciplinary approach including endodontic, periodontal, surgical, and orthodontic treatment, as well as esthetic coronal restoration.…”

“…[8][9][10] Occurrence of replacement resorption is influenced by factors such as the extra-alveolar period 11 , preservative solution 12 , pulpal revascularization 13 , and microbial contamination. 14 Treatment, often complex, time-consuming, and expensive, requires a multidisciplinary approach including endodontic, periodontal, surgical, and orthodontic treatment, as well as esthetic coronal restoration. 15 Root resorption may be transitory or progressive.…”

“…16 The probability of successful autotransplantation increases when an avulsed tooth is 6 immediately transplanted or stored in a solution that preserves periodontal ligament (PDL) on the root. 11,14,17,18 PDL cells are easily injured under stressful conditions such as variable pH, osmotic pressure or dehydration, and favorable healing of the PDL depends on the quantity of viable cells preserved on the root. 1 Andreasen 11 showed that only 21% of normal periodontium was hisopathologically observed when extracted tooth was left in a dry condition for 60 min.…”

The Hidden Treasure in Apical Papilla: The Potential Role in Pulp/Dentin Regeneration and BioRoot Engineering

“…Andreasen et al (31,32) and Kling et al (33) showed excellent radiographic images of the ingrowth of bone and periodontal ligament (PDL) (next to the inner dentinal wall) into the canal space with arrested root formation after the replantation of avulsed maxillary incisors, suggesting a complete loss of the viability of pulp, apical papilla, and/or HERS. Some cases showed partial formation of the root accompanied with ingrowth of bone and PDL into the canal space, and in some cases the teeth continued to develop roots to their completion, suggesting that there was partial or total pulp survival after the replantation.…”

Effect of zoledronic acid used in the root surface treatment of late replanted teeth: a study in rats

“…Nevertheless, despite these treatments, unsuccessful cases are still numerous, and after a mean period of 4 to 6 years, the teeth are ultimately lost (13). Thus, the search for new substances that may inhibit or delay the effects of root resorption and promote the repair in the space occupied by the periodontal ligament is essential.…”