title: Retention and Healing Outcomes after Intentional Replantation.
abstract: BACKGROUND
  Intentional replantation is an alternative to tooth extraction and prosthetic replacement when conventional endodontic treatment modalities are unfeasible or contraindicated. This study assessed tooth retention and healing after intentional replantation and explored predictors of these outcomes.
  
  
  METHODS
  Data of intentional replantation procedures performed between March 2000 and December 2010 were collected prospectively, excluding teeth with preoperative periodontal and root defects. A cohort of 159 teeth was followed up for 0.5-12 years. Retention and healed status without complications (periapical radiolucency, external root resorption, ankylosis, signs/symptoms, probing ≥6 mm) was recorded and analyzed with Kaplan-Meier survival analysis and Cox proportional hazard regression model (P < .05).
  
  
  RESULTS
  Complications leading to extraction occurred in 8 of 159 teeth (5%). Kaplan-Meier survival function suggested 93% cumulative 12-year retention. Cumulative healed rates declined from 91% at 6 months to 77% at 3 years. The healed rate was significantly lower for maxillary teeth without preoperative periapical radiolucency, replanted in more than 15 minutes, and root-end filled with ProRoot MTA. Cox regression identified extraoral time ≤15 minutes as predictor of complication-free healing (P < .04; hazard ratio, 2.767; 95% confidence interval, 1.053-7.272).
  
  
  CONCLUSIONS
  This prospective cohort study of contemporary intentional replantation suggested a cumulative 12-year retention rate of 93% and healed rate of 77% after 3 years. Healing occurred 1.7 times more frequently in teeth replanted within 15 minutes. Although most complications occurred within 1 year after replantation, follow-up should extend for at least 3 years to capture late complications.
authors.affiliation: Department of Dentistry and Institute for Translational and Clinical Research, International St Mary's Hospital, Catholic Kwandong University, Incheon, Korea.
authors.forename: Sin-Yeon
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Conservative Dentistry, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Conservative Dentistry, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Su-Jung
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Euiseong
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Jung
authors.affiliation: Disciplines of Endodontics, University of Toronto, Toronto, Ontario, Canada. Electronic address: shimon.friedman@dentistry.utoronto.ca.
authors.forename: Shimon
authors.initials: S
authors.lastname: Friedman
authors.affiliation: Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea. Electronic address: sjlee@yuhs.ac.
authors.forename: Seung-Jong
authors.initials: SJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000359:Aftercare; D000844:Ankylosis; D005260:Female; D006801:Humans; D008297:Male; D063868:Patient Outcome Assessment; D010485:Periapical Periodontitis / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea; D012391:Root Resorption / Q000209:etiology; D016019:Survival Analysis; D013997:Time Factors; D014076:Tooth Diseases / Q000209:etiology; D014081:Tooth Extraction; D014090:Tooth Replantation / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D014092:Tooth Root; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Extraoral time; healing outcome; intentional replantation; survival rate