Extraoral endodontic treatment by retrograde insertion of posts: a long-term study on replanted and transplanted teeth.
OBJECTIVE
The aim of the study was to investigate the healing results of teeth replanted or transplanted in different indications and treated by extraoral root canal therapy.


METHODS
Extraoral root canal treatment was performed from a retrograde direction with posts made of ceramics or titanium. Preoperatively, the pulp status was classified as definitely infected (n = 47) or not infected/symptomless (n = 78), and the condition of the periodontal ligament (PDL) was classified as damaged (n = 50) or not damaged (n = 75) according to trauma type and extraoral storage. The healing after replantation or transplantation was diagnosed as functional, ankylosis, or infection depending on clinical and radiographic findings.


RESULTS
In total, 125 teeth in 99 patients were replanted or transplanted. Mean observation period was 44.4 months. Teeth with a less damaged PDL in no case exhibited ankylosis/replacement resorption after a mean observation period of 53 months. Teeth without preoperative infection of the pulp in no case showed infection-related complications after a mean observation period of 30 months. Teeth classified as definitely infected before treatment had a high frequency of continuous periradicular bone and root resorption.


CONCLUSIONS
The extraoral insertion of posts appeared to inflict no additional damage to the PDL that was clinically relevant. Infection-related complications were prevented. Teeth that were classified as definitely infected at the time of treatment had a low rate of healing and should undergo conventional root canal disinfection before this surgical procedure is applied.
Pohl
Yango
Y
Department of Oral Surgery, University of Bonn, Germany. ypohl@uni-bonn.de
Filippi
Andreas
A
Kirschner
Horst
H
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000517:prevention & control; D002648:Child; D003790:Dental Pulp Necrosis / Q000150:complications / Q000209:etiology; D005260:Female; D006801:Humans; D007180:Incisor; D008297:Male; D008437:Maxilla; D010513:Periodontal Ligament / Q000502:physiology*; D011176:Post and Core Technique; D012184:Retrograde Obturation / Q000379:methods*; D012391:Root Resorption / Q000209:etiology / Q000517:prevention & control; D014070:Tooth / Q000637:transplantation; D020254:Tooth Ankylosis / Q000209:etiology / Q000517:prevention & control; D014084:Tooth Avulsion / Q000601:surgery; D014081:Tooth Extraction; D014090:Tooth Replantation