Treatment of replacement resorption by intentional replantation, resection of the ankylosed sites, and Emdogain®- results of a 6-year survey

• Published in: Dental traumatology 2006-12, Vol.22 (6), p.307-311
• Main Authors: Filippi, Andreas, Pohl, Yango, Von Arx, Thomas
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; ankylosis; Child; Dental Enamel Proteins - therapeutic use; Dentistry; Emdogain; Humans; intentional replantation; Longitudinal Studies; replacement resorption; Root Canal Filling Materials - therapeutic use; Secondary Prevention; Time Factors; Tooth Ankylosis - drug therapy; Tooth Ankylosis - prevention & control; Tooth Replantation - adverse effects; Tooth Resorption - drug therapy
• ISSN: 1600-4469; 1600-9657
• DOI: 10.1111/j.1600-9657.2005.00363.x

–  The present clinical study investigated the outcome of intentional replantation using resection of the ankylosed sites of the root, extraoral endodontic treatment using titanium posts and Emdogain® for periodontal healing following trauma‐related ankylosis. During an evaluation period of 6 years, 16 ankylosed teeth affected by replacement resorption were treated as described. Evaluation parameters before treatment and during the follow‐up period included Periotest® scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. In a second accident, one tooth was lost after 7 months and was excluded as a dropout. Ankylosis did not recur in seven replanted teeth, which were observed for an average of 52.3 months (range: 24–68 months). Ankylosis recurred in eight teeth after an average period of 12 months (range: 4–26 months). An infraocclusion, normal or only slightly reduced Periotest® scores and normal percussion sound were preoperatively found in six of seven successfully replanted teeth, which corresponded to a relatively small area of ankylosis. The majority of the teeth showing recurrent ankylosis preoperatively presented with normal position, negative Periotest® scores and a high percussion sound which corresponded to an extended area of ankylosis. Statistically significant relationship between preoperative findings and the treatment outcome (P = 0.031) have become apparent. The results indicate that the treatment of minor areas of ankylosis by intentional replantation, resection of the ankylosed sites and Emdogain® appeared to prevent or delay the recurrence of ankylosis in 7 of 15 teeth.