Replantation of 45 avulsed permanent teeth: a 1-year follow-up study.
Thirty-four patients with 45 avulsed and replanted permanent teeth were followed for 1 year. All teeth were soaked in tetracycline before replantation. In addition, enamel matrix derivative was used in teeth with dry storage times exceeding 30 min. Splinting was carried out with a non-rigid titanium splint and was limited to 7-10 days. Within that period, root canal treatment was begun in all teeth with a closed apex, whereas teeth with an open apex and ideal post-traumatic storage were not instrumented. All patients were given tetracycline systematically for 10 days. The survival rate of replanted avulsed permanent teeth was 95.6% at the 1-year follow-up. In 82.2%, root canal treatment was performed. Pulp survival was never observed, but three teeth had pulp canal obliteration. Normal periodontal healing was observed in 57.7% of teeth; 42.3% of teeth showed external root resorption (28.9% replacement resorption, 6.7% infection-related resorption, 6.7% surface resorption). The occurrence of replacement resorption correlated with the period of extraoral dry storage. Compared with other clinical studies on avulsed and replanted teeth, the present study reports a higher percentage of periodontal healing. The favorable treatment outcome may be associated with a strict protocol to enforce endodontic treatment, the use of topical and systemic tetracycline, and the relatively high number of ideally stored teeth following avulsion. In contrast, the present study has a follow-up period limited to 1 year.
Chappuis
Vivianne
V
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Switzerland. vivianne.chappuis@zmk.unibe.ch
von Arx
Thomas
T
D000293:Adolescent; D000328:Adult; D018786:Bone Substitutes / Q000627:therapeutic use*; D002648:Child; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012390:Root Canal Therapy / Q000379:methods*; D016019:Survival Analysis; D014084:Tooth Avulsion / Q000628:therapy*; D014090:Tooth Replantation / Q000379:methods*
D018786:Bone Substitutes; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins