Delayed tooth replantation: MTA as root canal filling

Area of Science:

• Endodontics
• Dental Traumatology
• Regenerative Dentistry

Background:

• Root-end filling materials are crucial for successful tooth repair.
• Mineral trioxide aggregate (MTA) and calcium hydroxide (Ca(OH)2) share similar mechanisms of action.
• Delayed tooth replantation presents challenges in achieving favorable healing outcomes.

Purpose of the Study:

• To compare the efficacy of MTA and Ca(OH)2 as root canal filling materials in delayed replantation of monkey teeth.
• To evaluate the repair processes, including resorption and ankylosis, following delayed replantation.
• To assess the potential of MTA as a root-end filling material in challenging clinical scenarios.

Main Methods:

• Extraction and 60-minute bench-drying of monkey lateral incisors.
• Root canal preparation followed by filling with either Ca(OH)2 or MTA.
• Standardized treatment sequence including coronal seal, PDL removal, fluoride treatment, socket irrigation, and replantation.
• Histological evaluation of repair outcomes, focusing on inflammatory root resorption, replacement resorption, and ankylosis.

Main Results:

• Both Ca(OH)2 and MTA groups demonstrated replacement resorption and absence of inflammatory root resorption.
• No statistically significant difference was found between MTA and Ca(OH)2 regarding replacement root resorption (p > 0.05).
• A significant difference was observed in the occurrence of ankylosis, with MTA showing a potentially lower rate (p < 0.05).

Conclusions:

• MTA is a viable clinical option for root-end filling in delayed tooth replantation cases.
• MTA is an acceptable material for treating replanted permanent teeth to prevent resorption, particularly when frequent dressing changes are impractical.
• Both MTA and Ca(OH)2 are effective in preventing inflammatory root resorption, but MTA may offer advantages in reducing ankylosis.