title: Periodontal healing following avulsion and replantation of teeth: a multi-centre randomized controlled trial to compare two root canal medicaments.
abstract: BACKGROUND
  Non-setting calcium hydroxide (Ultracal XS(®) ) is recommended by the International Association of Dental Traumatology as the initial medicament following avulsion and replantation for mature teeth. There is experimental evidence to suggest Ledermix(®) , placed as an alternative inter-visit dressing may improve periodontal healing.
  
  
  OBJECTIVE
  This study investigated, using a multi-centre randomized controlled trial, the effect of two root canal medicaments, Ledermix(®) and Ultracal XS(®) , on periodontal healing of avulsed and replanted teeth.
  
  
  METHODS
  Children were recruited if they fulfilled all inclusion criteria. Treatment followed a standardized protocol. Assessment of periodontal healing or ankylosis was made clinically and radiographically by an experienced, 'blinded', clinician at 12months.
  
  
  RESULTS
  Over 200 patients were assessed for eligibility at five centres. Twenty-nine patients were eligible for inclusion. Final analysis involved 22 patients with 27 teeth. Ankylosis was detected in four of the 12 teeth in the Ledermix(®) group and nine of 15 in the Ultracal XS(®) group. No significant difference between medicaments was found in the proportion of teeth or patients showing periodontal healing.
  
  
  CONCLUSIONS
  There was no significant difference in periodontal healing between the two medicaments at either a tooth or patient level. The numbers recruited fell short of an estimated power calculation. For patients meeting the inclusion criteria and completing the trial, periodontal healing was seen in 52% of teeth at the 12-month assessment between both groups. The only factor found to significantly influence the periodontal outcome was dry time.
authors: Leeds Dental Institute, Leeds Belfast Children's Hospital, Belfast Eastman Dental Institute, London, UK. p.f.day@leeds.ac.uk
authors: Peter F
authors: PF
authors: Day
authors: Terry A
authors: TA
authors: Gregg
authors: Paul
authors: P
authors: Ashley
authors: Richard R
authors: RR
authors: Welbury
authors: Ben O
authors: BO
authors: Cole
authors: Alec S
authors: AS
authors: High
authors: Monty S
authors: MS
authors: Duggal
mesh_terms: D000293:Adolescent; D002126:Calcium Hydroxide / Q000627:therapeutic use; D002648:Child; D003707:Demeclocycline / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010513:Periodontal Ligament / Q000503:physiopathology*; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D012390:Root Canal Therapy / Q000379:methods; D012391:Root Resorption / Q000517:prevention & control; D016037:Single-Blind Method; D020254:Tooth Ankylosis / Q000517:prevention & control; D014084:Tooth Avulsion / Q000628:therapy*; D014090:Tooth Replantation / Q000379:methods*; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D014945:Wound Healing / Q000502:physiology
chemical_list: D004338:Drug Combinations; D012388:Root Canal Irrigants; C531021:UltraCal XS; D003707:Demeclocycline; C001527:Ledermix; D014222:Triamcinolone Acetonide; D002126:Calcium Hydroxide