Intentional replantation of adhesively reattached vertically fractured maxillary single-rooted teeth.
OBJECTIVE
To evaluate the clinical outcomes of intentionally replanted maxillary single-rooted teeth with vertical root fractures (VRFs) after being repaired extraorally using 4-methacryloxyethyl trimellitate anhydride/methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin cement.


METHODS
Twenty-one root filled maxillary single-rooted teeth with VRFs were evaluated. After atraumatic extraction, fractured fragments were adhesively cemented. The teeth were then replanted and splinted to the neighbouring teeth for 2 weeks. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) were assessed at baseline, 6 and 12 months, and radiographic evaluations were made using PAI scores at baseline and 12 months. Mobility was evaluated using periotest values (PTV) at baseline, 1, 3, 6 and 12 months. Replanted teeth, contralateral teeth (control teeth) and adjacent teeth were analysed statistically using repeated measures one-way anova, unpaired t-tests and Wilcoxon matched-pairs signed-rank tests.


RESULTS
Two teeth were extracted in the first month after surgery. PI, GI, CAL and PD scores of the replanted teeth were significantly lower at 6 month (P < 0.0001 for all) and 12 month (P < 0.0001 for all) postoperatively when compared to baseline, but the values were not significantly different from those of the control and adjacent teeth. PTV of the test teeth increased significantly (P < 0.0001) after the intervention and decreased to baseline levels by month 12. PTVs were significantly higher (P < 0.05) at baseline, 1, 3 and 6 months in the test teeth when compared with the control teeth, but were not significantly different at month 12. PAI scores of teeth with VRF were significantly lower (P < 0.05) at 12 months compared with baseline.


CONCLUSIONS
Adhesive cementation and intentional replantation were an effective treatment modality for this group of vertically fractured maxillary single-rooted teeth. The clinical periodontal parameters decrease by month 6, and the mobility returned to the physiological limits of natural teeth 12 months after replantation.
Department of Periodontology, School of Dentistry, Turkey.
N
N
Nizam
Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey.
M E
ME
Kaval
Department of Periodontology, School of Dentistry, Turkey.
Ö
Ö
Gürlek
Department of Periodontology, School of Dentistry, Turkey.
A
A
Atila
Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey.
M K
MK
Çalışkan
D000328:Adult; D001896:Boron Compounds / Q000627:therapeutic use*; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008689:Methacrylates / Q000627:therapeutic use*; D008768:Methylmethacrylates / Q000627:therapeutic use*; D008875:Middle Aged; D010512:Periodontal Index; D019279:Resin Cements / Q000627:therapeutic use*; D012390:Root Canal Therapy; D014082:Tooth Fractures / Q000628:therapy*; D014090:Tooth Replantation / Q000379:methods*; D016896:Treatment Outcome
D001896:Boron Compounds; D008689:Methacrylates; D008768:Methylmethacrylates; D019279:Resin Cements; C049495:Super-bond
adhesive bonding; intentional replantation; periodontal healing; vertical root fracture