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Published on: January 28, 2020
Clinical outcome of intentional replantation with preoperative orthodontic extrusion: a retrospective study
1Department of Conservative Dentistry, School of Dentistry, Seoul National University, Seoul, Korea; Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.
Aim:
To evaluate retrospectively the clinical outcomes of intentional replantation (IR) of teeth in terms of tooth survival and periradicular healing and to investigate their prognostic factors.
Methodology:
Two hundred and eighty-seven teeth treated by IR were analysed retrospectively. Clinical outcomes between the cases with preoperative orthodontic extrusion for 2-3 week and those without extrusion were analysed. The outcomes of IR were determined by clinical and radiographic evaluation. Tooth survival and periradicular healing estimates were compared using Kaplan-Meier analysis. The contribution of a patient's age and gender, tooth type and location, and preoperative orthodontic extrusion was investigated using the multivariate Cox proportional hazard model.
Results:
The mean follow-up period was 25.4 ± 9.3 months. The overall success rate of IR was 89.5% based on periradicular healing. The overall survival rate was 95.1%. The survival rates were 91.2% for the teeth extracted without extrusion and 98.1% for those extracted with extrusion. Amongst the variables tested, only the extraction technique with preoperative orthodontic extrusion significantly affected the survival rate (P = 0.016). Other prognostic variables, such as age and gender, tooth type and location, did not affect the survival of intentionally replanted teeth.
Conclusions:
Intentional replantation was a viable treatment option for teeth with previously failed nonsurgical root canal treatment, regardless of a patient's age and gender, and tooth type and location. Preoperative orthodontic extrusion for 2-3 weeks reduced root resorption and tooth fracture and can be recommended to enhance the outcome of IR.
