Treatment of replacement resorption with Emdogain--a prospective clinical study

The present clinical study investigated the outcome of intentional replantation using Emdogain for periodontal healing following trauma-related ankylosis. Sixteen ankylosed teeth affected by replacement resorption were treated as follows: After tooth extraction, the root canal was obturated with a retrograde titanium post. Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical Periotest scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. The mean follow-up period was 15 months (range 4-24 months). Eleven teeth showed no signs of recurrence of ankylosis: they were in full function and exhibited no pathological clinical findings. Four severely traumatized teeth demonstrated a recurrence of ankylosis after a mean period of 6 months, one tooth was lost in a second accident after 7 months. The estimated probability of 1 year without recurrence of ankylosis was P=0.66 (95% confidence interval [0.40; 0.94]). The mean survival time was 10.2 months (SD 1.1). The results indicate that treatment of replacement resorption following light to moderate trauma with replantation and Emdogain appears to prevent or delay recurrence of ankylosis in many cases.