Extraoral apical elongation of deeply damaged roots with titanium posts. A comparison of 2 methods

42 very deeply fractured or otherwise damaged single roots which could not be saved by intra-alveolar transplantation only were replanted to a supragingival level after extraoral transapical elongation by either an ordinary titanium root screw (method 1) or a specially designed titanium post (TransApex, Dentatus) (method 2). After observation periods of x = 73 months (method 1) and x = 34 months (method 2), 61% and 85% of the cases-respectively, were considered successful, fulfilling all 5 predefined success criteria. No other resorptions than slight surface resorptions were seen and all teeth showed very shallow pocket depths and physiological mobility, indicating that the long extraoral treatment had not caused lasting traumatic injury to the PDL cells. The most frequent complication in method 1 was periapical osteitis, indicating that the elongation system had become insufficient. On the other hand, the method showed the capacity to heal many of the pre-existing osteitis cases. Both root elongation techniques described in this report are comparatively inexpensive and safe, since the apical elongation is never extended beyond the lamina dura structure of the alveolus. Method 2 is to be preferred, however, as the specially designed through-and-through post-system which simultaneously provides apical closure, transapical elongation and coronal retention, allows treatment of even very short roots and seems to give better results.