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Maier E, Zentgraf J, Angele E, Zorzin J, Taschner M, Widbiller M, Galler K, Schratzenstaller T. A re-usable 3D-printed training model for the endodontic management of dental trauma in immature teeth. Int Endod J 2025. [PMID: 40205914 DOI: 10.1111/iej.14235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2025] [Revised: 03/25/2025] [Accepted: 03/26/2025] [Indexed: 04/11/2025]
Abstract
AIM To develop a 3D-printed model enabling treatment simulation of trauma-related endodontic and restorative procedures like revitalization or placement of an apical plug on teeth with incomplete root formation. METHODOLOGY To generate a realistic training model suitable for trauma-related simulations, CT-Data sets were segmented, combined, adjusted and optimized using computer-aided design features. Specific focus was on optimally reflecting characteristics of immature teeth like open apical foramina and thin root walls. For reflection of the revitalization process, a set-up including a tube filled with red liquid under pressure was developed to be perforated during the procedure by the trainee, simulating bleeding from the apical papilla into the root canal system. Design was based on a combination of cost-effective simple parts combined with 3D-printed components to achieve maximal accessibility, exchangeability and re-usability. Model assembly and preparation were described in step-by-step instructions. RESULTS As a result of the developmental process, the presented model qualifies for the training of the endodontic management of complications on immature teeth after dental trauma. Step-by-step descriptions aligned with the clinical procedures are performable for a revitalization procedure, for pulpotomy followed by fragment re-attachment and splint application and for placement of an apical plug using hydraulic calcium silicate cements. CONCLUSIONS The model successfully achieved its intended objectives, so that it may be used in the future in various dental trauma treatment simulations for undergraduate and postgraduate education on the endodontic management of trauma-related therapies in immature teeth. Its common manufacturing process, affordability and re-usability support accessibility and sustainability.
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Affiliation(s)
- Eva Maier
- Department of Operative Dentistry and Periodontology, University Hospital Erlangen, Erlangen, Germany
| | - Jan Zentgraf
- Laboratory for Medical Devices, Department of Mechanical Engineering, University of Applied Sciences Regensburg, Regensburg, Germany
- Regensburg Center of Health Sciences and Technology (RCHST), University of Applied Sciences Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering (RCBE), University of Applied Sciences Regensburg, Regensburg, Germany
| | - Eveline Angele
- Laboratory for Medical Devices, Department of Mechanical Engineering, University of Applied Sciences Regensburg, Regensburg, Germany
| | - José Zorzin
- Department of Operative Dentistry and Periodontology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Taschner
- Department of Operative Dentistry and Periodontology, University Hospital Erlangen, Erlangen, Germany
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Kerstin Galler
- Department of Operative Dentistry and Periodontology, University Hospital Erlangen, Erlangen, Germany
| | - Thomas Schratzenstaller
- Laboratory for Medical Devices, Department of Mechanical Engineering, University of Applied Sciences Regensburg, Regensburg, Germany
- Regensburg Center of Health Sciences and Technology (RCHST), University of Applied Sciences Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering (RCBE), University of Applied Sciences Regensburg, Regensburg, Germany
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Bhanderi S, Patel K. Surgical endodontics. Br Dent J 2025; 238:497-507. [PMID: 40217032 DOI: 10.1038/s41415-025-8406-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2024] [Revised: 01/10/2025] [Accepted: 01/21/2025] [Indexed: 04/22/2025]
Abstract
This article aims to provide general dentists with an overview into the applications of surgery in endodontics. The article will discuss the following: apical surgery; surgical management of perforations; surgical management of external cervical root resorption; intentional replantation; and functional crown lengthening in conjunction with endodontics.
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Affiliation(s)
- Sanjeev Bhanderi
- Specialist in Endodontics, Senior Lecturer, ENDO61 Ltd, Specialist Endodontic Practice, Cheshire, UK; University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Kreena Patel
- Specialist in Endodontics, Brigstock Dental, South London, UK; Oaktree Dental, Reading, United Kingdom.
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3
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Wu S, Lui JN. Intentional Replantation of C-shaped Mandibular Second Premolar with Radicular Groove. J Endod 2025:S0099-2399(25)00144-X. [PMID: 40118269 DOI: 10.1016/j.joen.2025.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Revised: 03/10/2025] [Accepted: 03/10/2025] [Indexed: 03/23/2025]
Abstract
C-shaped roots with radicular grooves are uncommon in mandibular premolars. Bacteria residing in the radicular groove and associated accessory canals can contribute to persistent periradicular infections. Eradicating bacteria in these less accessible areas remains a significant challenge in endodontic procedures. This report describes the successful management of a left mandibular second premolar (#20) with a persistent lesion related to a lingual radicular groove through an intentional replantation procedure. A 31-year-old Chinese male complained of a gum swelling related to tooth #20 which was endodontically treated and crowned 6 years ago. Clinical examination revealed a lingually located sinus tract and a clinically intact crown restoration. The tooth was not tender to percussion or palpation, with probing depths not exceeding 4 mm, and showed physiological mobility. A periapical radiograph showed the lingual sinus tract traced to the mid third of the root, which had an adequate root canal filling and an intact periodontal ligament around the apical region. A cone-beam computed tomography image revealed radiolucency at the mid third region and on the lingual aspect related to the radicular groove of this C-shaped premolar. Intentional replantation was performed due to the location of the mid-root lesion related to the lingual radicular groove. Tooth #20 was extracted atraumatically, a stained radicular groove was identified, cleansed and sealed with Biodentine, and the tooth replanted. At 2.5-year follow-up, the patient was clinically asymptomatic. Tooth #20 presented with normal probing depths and mobility and healing was observed on the cone-beam computed tomography images.
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Affiliation(s)
- Siwen Wu
- National Dental Centre Singapore (NDCS), Singapore, Singapore.
| | - Jeen Nee Lui
- National Dental Centre Singapore (NDCS), Singapore, Singapore
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Babiuc I, Diaconeasa MȘ, Perieanu VȘ, Malița MA, Beuran IA, Burlibașa M. Case Report: Digitally driven tooth autotransplantation using surgical templates and three-dimensional printed donor tooth replica. FRONTIERS IN ORAL HEALTH 2025; 6:1537468. [PMID: 40177660 PMCID: PMC11961978 DOI: 10.3389/froh.2025.1537468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2024] [Accepted: 03/06/2025] [Indexed: 04/05/2025] Open
Abstract
Tooth autotransplantation is a procedure involving the surgical repositioning of a tooth or dental germ from one site in the mouth to another within the same individual. A successful procedure requires a donor tooth with healthy cementum and periodontium, gentle surgical maneuvers, a well-fitted neoalveolus, and a short extraalveolar time of the donor tooth. Digital technology increases the accuracy and predictability of the tooth autotransplantation procedure. Surgical templates generate a more precise neoalveolus, with good stability of the donor tooth, and decrease the surgical time. Using a donor tooth replica ensures an optimal morphology of the new alveolus, thus reducing the injury of the root and the extraoral time of the donor tooth. This case report presents the tooth autotransplantation technique, that was employed to reposition a maxillary premolar with two fused roots on a mandibular recipient site. Digital planning, two surgical guides (one for each root), and a 3D printed tooth replica were used to ensure good accuracy, prognosis, and reduced treatment time. The procedure is conservative and offers considerable advantages to the patient, such as retaining natural teeth and proprioception.
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Affiliation(s)
- Iuliana Babiuc
- Department of Dental Technology, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Viorel Ștefan Perieanu
- Department of Dental Technology, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mădălina Adriana Malița
- Department of Dental Technology, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina Adriana Beuran
- Department of Dental Technology, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Burlibașa
- Department of Dental Technology, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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5
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Lin Z, Huang D, Huang S, Chen Z, Yu Q, Hou B, Qiu L, Chen W, Li J, Wang X, Huang Z, Yu J, Zhao J, Pan Y, Pan S, Yang D, Niu W, Zhang Q, Deng S, Ma J, Meng X, Yang J, Wu J, Zhang L, Zhang J, Xie X, Chu J, Que K, Ge X, Huang X, Ma Z, Yue L, Zhou X, Ling J. Expert consensus on intentional tooth replantation. Int J Oral Sci 2025; 17:16. [PMID: 40025031 PMCID: PMC11873174 DOI: 10.1038/s41368-024-00337-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 11/08/2024] [Accepted: 11/08/2024] [Indexed: 03/04/2025] Open
Abstract
Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
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Affiliation(s)
- Zhengmei Lin
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuheng Huang
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College & Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jinhua Yu
- Department of Endodontics, Jiangsu Key Laboratory of Oral Diseases, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yihuai Pan
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Shuang Pan
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, China
| | - Deqin Yang
- Department of Conservative Dentistry and Endodontics, Shanghai Stomatological Hospital & School of Stomatology, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Weidong Niu
- School of Stomatology, Dalian Medical University, Dalian, Liaoning, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jingzhi Ma
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiuping Meng
- Hospital of Stomatology, Jilin University, Changchun, China
| | - Jian Yang
- Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Jiayuan Wu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jin Zhang
- Shandong University, School of Stomatology, Jinan, Shandong, China
| | - Xiaoli Xie
- Department of Endodontology, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Jinpu Chu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kehua Que
- Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin, China
| | - Xuejun Ge
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Disease & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Zhe Ma
- Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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6
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Yoshihashi N. Feasibility and Outcomes of Cell-based Regenerative Endodontic Therapy in Postautogenous Transplantation of a Mature Tooth: A Case Report. J Endod 2025; 51:85-93. [PMID: 39528015 DOI: 10.1016/j.joen.2024.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Revised: 10/18/2024] [Accepted: 11/03/2024] [Indexed: 11/16/2024]
Abstract
Autogenous tooth transplantation (ATT) offers advantages; however, success rates depend on factors like socket formation, donor tooth manipulation, and endodontic treatment. Root canal treatment in a mature post-ATT tooth remains challenging. Cell-based regenerative endodontic therapy (RET) shows promise for regenerating the pulp-dentin complex in mature teeth. However, its application in a post-ATT tooth is unexplored. This case report demonstrates the feasibility and outcomes of cell-based RET in a post-ATT tooth. A 37-year-old male underwent ATT for a missing maxillary left first molar. The maxillary right third molar served as the donor tooth and transplanted with surgical guides. Root canal treatment began two weeks after ATT, confirming no detectable residual bacteria and fungi after 11 weeks. Dental pulp stem cells isolated from the maxillary left third molar were transplanted into the root canal 17 weeks after ATT. The ATT tooth responded positively to the electric pulp test after 1 week. Most of the periodontal ligament of the donor tooth was absent, and the ATT tooth initially showed ankylosis-like signs but regained normal mobility after 28 weeks after RET. Cone-beam computed tomography imaging showed successful outcomes with the presence of the periodontal ligament space and lamina dura, and without root resorption and ankylosis after 52 weeks. Magnetic resonance imaging revealed signal intensity of the regenerated tissue comparable to normal pulp after 60 weeks. This case report suggests the effectiveness of dental pulp stem cells in regenerating dental pulp and periodontal ligament, potentially preventing root resorption and ankylosis in the post-ATT tooth.
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Affiliation(s)
- Noriaki Yoshihashi
- Good Bridge Medical Corporation, Tooth Clinic Tokyo, Chuo-ku, Tokyo, Japan.
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7
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Grippaudo C, Cafiero C, Grande NM, Dassatti L, Palmirotta R, Castagnola R, Isola G. Genetic Testing as a Source of Information Driving Diagnosis and Therapeutic Plan in a Multidisciplinary Case. Bioengineering (Basel) 2024; 11:1023. [PMID: 39451399 PMCID: PMC11505315 DOI: 10.3390/bioengineering11101023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 10/06/2024] [Accepted: 10/09/2024] [Indexed: 10/26/2024] Open
Abstract
In many cases, the etiopathogenesis of oral cavity diseases depends on the presence of variants in some genes. Being able to identify these variants defines the possibilities and limits of therapies. This multidisciplinary case describes several pathologies of the oral cavity in a young patient affected by type 1 diabetes. The patient presented with an impacted palatal canine. Further investigation revealed cervical root resorption of the upper right central incisor. Genetic testing was performed for interleukin, VDR receptor genes, and the evaluation of periodontopathogenic bacteria. The mutational analysis carried out for the VDR polymorphisms and the IL1A, IL1B, IL6, and IL10 polymorphisms showed the presence of pathogenetic variants. The results for bacterial load showed the presence of periodontal pathogenes. The first intervention was the intentional replantation of the incisor. The second intervention was the orthodontic recovery of the impacted canine, using light forces and a hybrid anchorage with a miniscrew. At the end of orthodontic treatment, a crack was found in the upper left first premolar, which was extracted. Throughout treatment, non-invasive periodontal interventions were performed periodically to control periodontal inflammation. This case is an example of the integration of genetic analyses into the multidisciplinary diagnostic pathway.
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Affiliation(s)
- Cristina Grippaudo
- UOC di Clinica Odontoiatrica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy;
- Dipartimento Universitario Testa Collo ed Organi di Senso, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.G.); (L.D.)
| | | | - Nicola Maria Grande
- Dipartimento Universitario Testa Collo ed Organi di Senso, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.G.); (L.D.)
| | - Leonardo Dassatti
- Dipartimento Universitario Testa Collo ed Organi di Senso, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.G.); (L.D.)
| | - Raffaele Palmirotta
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Raffaella Castagnola
- Dipartimento Universitario Testa Collo ed Organi di Senso, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.G.); (L.D.)
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95123 Catania, Italy;
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8
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Zhang Y, Ong DV. Interdisciplinary management of an adolescent patient with a severely impacted mandibular canine. Aust Dent J 2024; 69:232-243. [PMID: 38803113 DOI: 10.1111/adj.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/29/2024]
Abstract
Impacted mandibular canines often result in a variety of clinical dilemmas. Orthodontic disimpaction of severely displaced mandibular canines may be extremely challenging and associated with significant patient discomfort and a high risk of iatrogenic damage. This case report demonstrates the interdisciplinary management of a horizontally impacted permanent mandibular canine, utilising a combination of three-dimensional radiology, biomodel fabrication and subsequent endodontic treatment. © 2024 Australian Dental Association.
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Affiliation(s)
- Y Zhang
- Private Practice, Sydney, Australia
| | - Dc-V Ong
- Clinical Academic, Orthodontic Department, School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
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Moreno-Pérez J, Rubio Flores D, Fernández Villares C, Nagendrababu V, Abella Sans F. Guided tooth autotransplantation of a palatally impacted maxillary canine into the site of a failed maxillary canine implant. AUST ENDOD J 2024; 50:369-376. [PMID: 38509785 DOI: 10.1111/aej.12840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/12/2024] [Accepted: 03/10/2024] [Indexed: 03/22/2024]
Abstract
The aim of this report is to demonstrate the guided tooth autotransplantation of a palatally impacted maxillary canine into the site of a failed maxillary canine dental implant. A 47-year-old woman visited a dental clinic complaining of loose dental implant in the left maxillary canine site, tooth #11, as well as pain and swelling of the gum around the implant. The clinical examination revealed a mobile implant along with swollen soft tissues with bleeding on probing. A periapical radiograph demonstrated peri-implant marginal bone loss. Cone beam computed tomography sections revealed that tooth #11 was impacted palatally. The implant was removed and replaced with the impacted canine via guided autotransplantation and posterior orthodontic alignment. The patient was recalled at 1, 3, 6, 9, 12, 24 and 48 months after the procedure. During this period, the patient was symptom-free and radiographic examination at 2 years revealed no periapical pathosis or root resorption.
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Affiliation(s)
| | - David Rubio Flores
- Department of Conservative Dentistry and Prosthetics, Universidad Complutense de Madrid, School of Dentistry, Madrid, Spain
| | | | | | - Francesc Abella Sans
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
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10
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Zhao L, Hou Y, Wang J. Knowledge, attitudes, and practices among patients with combined dentition defect and non-functional impacted teeth toward tooth autotransplantation. BMC Oral Health 2024; 24:761. [PMID: 38965503 PMCID: PMC11225189 DOI: 10.1186/s12903-024-04545-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/28/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Tooth autotransplantation (TAT) is a surgical procedure involving the extraction of a tooth from one location and its subsequent transplantation into another alveolar socket within the same individual. This innovative treatment approach holds significant promise. Nonetheless, the potential recipients exhibit a limited level of awareness and understanding of this procedure. This study investigated the knowledge, attitudes, and practices (KAP) among patients with combined dentition defects and non-functional impacted teeth toward TAT. METHODS This web-based cross-sectional study was conducted between December 2022 and February 2023 at one hospital. A self-designed questionnaire was developed to collect demographic information of the patients and assess their knowledge, attitudes, and practices toward TAT. RESULTS A total of 533 valid questionnaires were collected. The mean knowledge, attitude, and practice scores were 5.55 ± 2.38 (possible range: 0-10), 26.82 ± 2.46 (possible range, 8-40), and 27.45 ± 7.40 (possible range, 9-45), respectively. CONCLUSION The participants had insufficient knowledge, negative attitudes, and passive practices toward TAT. Targeted interventions should be implemented to improve the understanding and practice of TAT among patients with dentition defects.
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Affiliation(s)
- Liang Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710000, China.
| | - Yuzhuan Hou
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710000, China
| | - Juan Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710000, China.
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11
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Luo Y, Li J, Liu L, Ye L, Song D, Huang D. Comparison of the Outcome of Intentional Replantation in Teeth with or without Periodontal Involvement: A Retrospective Study. J Endod 2024; 50:944-953. [PMID: 38588976 DOI: 10.1016/j.joen.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Intentional replantation (IR) is considered as a viable treatment option to preserve the teeth with apical periodontitis. This study aimed to compare the treatment outcomes of IR in teeth with or without periodontal involvement, and to investigate the influence of related factors. METHODS A total of 157 teeth with a documented history of IR between September 2012 and November 2022 and a follow-up duration of more than 1 year were included. The samples included 100 teeth with simple apical periodontitis and 57 teeth with combined periodontal-endodontic lesions (CPEL). Clinical and radiographic criteria were used to evaluate treatment outcomes including functional retention and extraction. Chi-square analyses and Fisher's exact tests were used to compare bivariate associations between outcomes and clinical or demographic variables. Kaplan-Meier analyses were used to evaluate the cumulative survival rate of the intentionally replanted teeth. RESULTS The overall cumulative survival rates were 93.0% at 1 year, 76.7% at 5 years, and 56.2% at 10 years. Among the 100 teeth with simple apical periodontitis, the survival rates were 93.0%, 86.7%, and 78.8% at the same time points. In contrast, 57 teeth with CPEL exhibited survival rates of 93.0%, 65.0%, and 36.9%, respectively. The primary postoperative complications that led to extraction were periodontal involvement (51.9%), tooth fracture (18.5%), external root resorption (18.5%), and persistent apical periodontitis (11.1%). The outcomes of teeth with CPEL were significantly affected by the presence of a sinus tract and crown restoration. In contrast, no significant prognostic factors were identified for teeth without periodontal involvement. CONCLUSION The long-term prognosis of teeth with CPEL is significantly worse than those with simple apical periodontitis. The main reason of extraction was periodontal involvement. Regular periodontal maintenance and appropriate crown restoration may help to improve the prognosis for teeth with CPEL.
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Affiliation(s)
- Yu Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiatong Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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12
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Chan AS, Chan AJ, Chan A, Armati P. Successful Intentional Replantation of a Severely Compromised Tooth Using 3 Types of Phototherapy: A Case Report. Photobiomodul Photomed Laser Surg 2024; 42:488-492. [PMID: 38700573 DOI: 10.1089/photob.2023.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/19/2024] Open
Abstract
Background: Intentional replantation (IR) is an emerging and cost-effective last-resort treatment for persistent apical periodontitis. Adjunctive phototherapy for IR aims to improve the management of challenging cases by enhancing disinfection, stimulating healing and promoting regeneration. Objective: We report a novel phototherapy-assisted IR protocol conducted on a compromised lateral incisor with an extensive periapical infection (Ø > 10 mm) in a 68-year-old diabetic male. Methods: The IR protocol involved pre- and postoperative photobiomodulation (660 nm, 0.2 J/cm2, 60 sec/site), antimicrobial photodynamic therapy of the root surface (660 nm, 0.6 J/cm2, 30 sec, methylene blue photosensitizer), and Er:YAG root and socket debridement (2940 nm, 21 J/cm2, 30 sec). The total time from extraction to replantation was 14 min 35 sec. Results: The tooth at 3.5-year follow-up remained clinically functional with radiographic resolution of the infection indicating a successful reimplantation. Conclusions: This case report demonstrated that an adjunctive phototherapy IR protocol can effectively treat a compromised tooth with extensive periapical infection.
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Affiliation(s)
- Alex Simon Chan
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Andrew Jonathan Chan
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Ambrose Chan
- Brain and Mind Centre, Neuroinflammation Group, The University of Sydney, Sydney, Australia
| | - Patricia Armati
- Brain and Mind Centre, Neuroinflammation Group, The University of Sydney, Sydney, Australia
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13
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Boreak N, Al Moaleem MM, Zain AA, Madkhali A, Arishy LM, Domari AA, Alhijji HH, Thubab HA. Surgical Extrusion of Three Premolars to Re-establish the Biological Width: Case Series. J Contemp Dent Pract 2024; 25:593-598. [PMID: 39364827 DOI: 10.5005/jp-journals-10024-3717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
AIM This case series was to describe the use of surgical extrusion for three different cases as a technique to re-establish the biological width in patients with insufficient crown height. BACKGROUND Surgical extrusion serves as an important means to reestablishing a proper biological width. Such method provides an excellent alternative for the restoration of teeth with insufficient ferrule and ensuring a suitable dental restoration. CASES DESCRIPTIONS This case series describes the management of three different cases with compromised teeth #25, #35, and #44, respectively. The approach involved the surgical extrusion of the compromised sites from subgingival to supragingival and the splinting of the teeth using a semi-rigid splint. A successful prognosis was observed on follow-up visits. CONCLUSION This technique is a good alternative for general practitioners because of its easy implementation and time efficiency. In addition, the method requires less equipment and provides for adequate space for the re-establishment of biological width. CLINICAL SIGNIFICANCE Such technique can re-establish a healthy biological width, the existing occlusion can be maintained without alterations, and it demonstrated the suitability of surgical extrusion technique in such clinical situations. Case selection is equally important. Cases with single-rooted teeth with fractures or caries in proximity to the marginal bone level without vertical root fractures generally provide positive outcomes on providing this treatment. How to cite this article: Boreak N, Al Moaleem MM, Zain AA, et al. Surgical Extrusion of Three Premolars to Re-establish the Biological Width: Case Series. J Contemp Dent Pract 2024;25(6):593-598.
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Affiliation(s)
- Nezar Boreak
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia, e-mail: , Orcid: https://orcid.org/0000-0001-9017-9224
| | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia, Phone: 00966550599553, e-mail: , Orcid: https://orcid.org/0000-0002-9623-261X
| | - Asma A Zain
- College of Dentistry, Jazan University, Jazan, Saudi Arabia, Orcid: https://orcid.org/0000-0003-1087-9437
| | - Alfaroog Madkhali
- College of Dentistry, Jazan University, Jazan, Saudi Arabia, Orcid: https://orcid.org/0009-0008-2112-7154
| | - Layla M Arishy
- College of Dentistry, Jazan University, Jazan, Saudi Arabia, Orcid: https://orcid.org/0009-0006-0146-4490
| | - Ahlam A Domari
- College of Dentistry, Jazan University, Jazan, Saudi Arabia, Orcid: https://orcid.org/0009-0001-1399-3748
| | - Haider H Alhijji
- College of Dentistry, Jazan University, Jazan, Saudi Arabia, Orcid: https://orcid.org/0009-0008-1260-3147
| | - Hamed A Thubab
- College of Dentistry, Jazan University, Jazan, Saudi Arabia, Orcid: https://orcid.org/0009-0001-9768-778X
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Sans FA, Vidal-Ponsoda C, Caponi LQ, Cayón MR, Nagendrababu V. Computer-aided design and computer-aided manufacturing poly (methyl methacrylate) interim veneers for immediate esthetic restoration of autotransplanted teeth. Dent Traumatol 2024; 40:325-332. [PMID: 37990814 DOI: 10.1111/edt.12910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/23/2023]
Abstract
Autotransplanted teeth in the maxillary anterior region should be restored or reshaped as soon as possible for functional and esthetic reasons as well as the well-being of the patient. However, such tooth restorations are frequently not carried out immediately after tooth transplantation because the process could have a negative impact on the healing process. The development of a simple, immediate, and atraumatic esthetic interim restoration would be of great benefit to both the clinician and patient and address all the concerns caused by immediately preparing the tooth postoperatively and cementing a permanent restoration. This report describes the use of CAD-CAM technology to create poly (methyl methacrylate) veneers preoperatively that can be cemented extraorally on the extracted donor tooth for the immediate and interim recontouring of autotransplanted anterior teeth.
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Affiliation(s)
- Francesc Abella Sans
- Department of Endodontics, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Carla Vidal-Ponsoda
- Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Lucas Queiroz Caponi
- Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
- Private practice, San Benedetto del Tronto, Italy
| | - Miguel Roig Cayón
- Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Venkateshbabu Nagendrababu
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, UAE
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Restrepo-Restrepo FA, Uribe-Jaramillo DF, Villa-Machado PA, Mejía-Cardona JL, Abella-Sans F, Morales-Quezada RK, Tobón-Arroyave SI. Retrospective Follow-up Assessment of Risk Variables Influencing the Outcome of Autologous Tooth Transplantation. J Endod 2024; 50:747-757. [PMID: 38442852 DOI: 10.1016/j.joen.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION This retrospective study aimed to identify which patient-, donor tooth-, recipient site-, and surgical procedure-related variables may influence the outcome of tooth autotransplantation. METHODS The sample included 128 autotransplants performed in 122 patients. Single-visit clinical/imaging examinations were used to define the outcome as successful, survival, or failure. The association of potential indicators with the survival or failure categories was analyzed individually and adjusted for confounders through multivariate logistic regression models. RESULTS After a follow-up period of 1 to 30.11 years, success was achieved in 71.8% of autotransplants, whereas the survival and failure groups had rates of 14.1% each, and the grouped success/survival rate reached 85.9%. An extraoral time >15 minutes and difficult handling/placement were strong/independent risk covariates for survival and failure categories (odds ratio >1, P < .05). Additionally, unerupted/partially erupted status of the donor tooth was a significant indicator for survival, whereas deficient bone level at the recipient site, surgical extraction, poor initial stability, and lack of prophylactic antibiotics were independently linked to failure (odds ratio > 1, P < .05). The root morphology and socket status acted as modifiers of the effect of the recipient site location on the survival group (P > .05). CONCLUSION Based on the results of this study, unerupted/partially erupted status of the donor tooth, surgical extraction, total extraoral time >15 minutes, deficient recipient's bone level, difficult handling/placement of the autotransplant, poor initial stability, and lack of prophylactic antibiotics during the surgical procedure must be considered with caution when performing autotransplantation because of their deleterious influence on the outcome.
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Affiliation(s)
| | - Diego F Uribe-Jaramillo
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Paula A Villa-Machado
- Graduate Endodontics Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - José L Mejía-Cardona
- Graduate Endodontics Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Francesc Abella-Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Reyna K Morales-Quezada
- Graduate Endodontics Program, Multidisciplinary Institute of Dental Specialties, Zapopan, México
| | - Sergio I Tobón-Arroyave
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
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Alam MN, Ibraheem W, Ramalingam K, Sethuraman S, Basheer SN, Peeran SW. Identification, Evaluation, and Correction of Supracrestal Tissue Attachment (Previously Biologic Width) Violation: A Case Presentation With Literature Review. Cureus 2024; 16:e58128. [PMID: 38741844 PMCID: PMC11089581 DOI: 10.7759/cureus.58128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
The supracrestal tissue attachment (SCTA) is the new terminology for biologic width. SCTA is defined as the physiologic dimension of a solitary functional unit composed of junctional epithelium and connective tissue attachment. Its preservation is critical for the well-being of periodontal health. SCTA has been widely studied and scientific literature is indicative of its significance during the placement of restoration, including prosthetic crowns. This should be taken care of in cases of anterior teeth within the smile zone, where dental crowns are regularly placed subgingivally for aesthetic reasons. In addition, any violation of SCTA while restoring the dentition will present as gingival inflammation and pain, consequently, leading to failure of the clinical procedure.
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Affiliation(s)
| | - Wael Ibraheem
- Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, SAU
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sathya Sethuraman
- Physiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Syed Nahid Basheer
- Restorative Dentistry, College of Dentistry, Jazan University, Jazan, SAU
| | - Syed Wali Peeran
- Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, SAU
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17
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Ferrando Cascales Á, Ferrando Cascales R, Lacal Luján J, Abella Sans F. Forced orthodontic extrusion for an apparently hopeless anterior tooth by using a simplified approach. J Prosthet Dent 2024; 131:361-369. [PMID: 36137812 DOI: 10.1016/j.prosdent.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 12/01/2022]
Abstract
When restoring severely compromised teeth, respecting the supracrestal tissue attachment and retaining the most coronal and radicular tooth structure is essential to achieving a sufficient ferrule. Forced orthodontic extrusion is a minimally invasive method that allows hard- and soft-tissue conservation. This article describes the treatment of a severely damaged maxillary central incisor that was managed by using a simplified orthodontic extrusion method with intracoronal elastic and metal ligatures applied through a palatal bar and followed by the biologically oriented preparation technique (BOPT). This orthodontic procedure reduces a forward clockwise advance during vertical extrusion, thus maintaining the buccal bone plate.
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Affiliation(s)
- Álvaro Ferrando Cascales
- Associate Professor, Faculty of Health Sciences, San Antonio de Murcia Catholic University (UCAM), Murcia, Spain
| | - Raúl Ferrando Cascales
- Associate Professor, Faculty of Health Sciences, San Antonio de Murcia Catholic University (UCAM), Murcia, Spain; Director of the Master with Exclusive Dedication in Orthodontics and Dentofacial Orthopedics (UCAM)
| | - José Lacal Luján
- Associate Professor, Department of Oral Surgery, University of Murcia, Murcia, Spain
| | - Francesc Abella Sans
- Director, Department of Restorative Dentistry and Endodontics, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.
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18
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Huang JW, Gan YN, Xu H, Han S, Zhu H, Jia L, Li N, Li DD, Cai ZG. Tooth intentional replantation from 1964 to 2023: A bibliometric analysis. Dent Traumatol 2024; 40:121-132. [PMID: 37646307 DOI: 10.1111/edt.12884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND/AIM There is no thorough overview of intentional tooth replantation techniques. We performed a bibliometric analysis of the development of intentional tooth replantation. MATERIALS AND METHODS A comprehensive search of the Web of Science and SCOPUS databases was conducted in February 2023. Original articles and reviews of human studies with "intentional replantation" or synonyms in the titles, abstracts, or keywords were included. A descriptive analysis of bibliographic data, co-occurrence analysis, and coupling of publications was performed. Multivariate analysis was used to explore the bibliometric parameters associated with the citation counts. RESULTS The study included 171 papers, which were co-authored by 500 individuals affiliated with 217 institutions from 28 countries/regions. The USA contributed the greatest number of publications, followed by China, and Japan. The USA had 694 citations, followed by Japan (210), and Turkey (210). The Journal of Endodontics and Dental Traumatology contributed the most citations. Five directions for future research were identified based on the coupling relationships of publications, including "managing vertical root fractures with adhesive resin using the intentional replantation technique," "intentional replantation for periodontally hopeless or endodontically compromised teeth," "intentional replantation for treating abnormalities of morphological development," "outcomes and prognosis factors of intentional replantation," and "treating root replacement resorption by intentional replantation." Multivariate analysis showed that the publication year, Journal Citation Reports ranking of journals, study design, and disease type were predictors of citation counts. CONCLUSIONS This bibliometric analysis provides a comprehensive description of the intentional replantation technique. The USA published the greatest volume of papers and generated the most citations. The Journal of Endodontics and Dental Traumatology are considered the most influential. The Journal Citation Reports journal ranking (Q1, Q2), study design (case reports, cohort studies), and disease type (crown root fractures) were associated with the citation counts.
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Affiliation(s)
- Jin-Wei Huang
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry II, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ye-Na Gan
- Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - He Xu
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Sheng Han
- Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - He Zhu
- Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Lu Jia
- Dental Laboratory Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Nan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Duo-Duo Li
- Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi-Gang Cai
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
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Abella Sans F, Suresh N, Dummer PMH, Garcia-Font M, Gómez-Rojas A, Nagendrababu V. Guided Autotransplantation of an Immature Premolar to the Maxillary Incisor Region with Immediate Restoration of Esthetics: A Case Report. J Endod 2024; 50:252-257. [PMID: 38000692 DOI: 10.1016/j.joen.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
This case report describes the treatment of two maxillary central incisors following a traumatic injury with tooth #8 developing replacement resorption and #9 developing inflammatory root resorption. A 10-year-old girl presented complaining of pain in her maxillary central incisors. Upon clinical examination, teeth #8 and #9 were tender to percussion and palpation of the buccal soft tissues. Thermal and electrical pulpal sensitivity tests for teeth #8 and #9 were negative. An intraoral periapical radiograph revealed resorptive defects in tooth #8, which were filled with bone-like tissue, while tooth #9 had radiolucent resorptive defects along the root surface and a periapical radiolucency. A diagnosis of replacement resorption was made for tooth #8 and external inflammatory root resorption for tooth #9. Tooth #8 was treated with a multidisciplinary approach utilizing a guided template for premolar autotransplantation with an immediate veneer restoration, while tooth #9 was managed with root canal treatment using a tricalcium silicate cement to fill the canal. At the 1, 4, 8, 12, and 24-month follow-ups, the patient remained asymptomatic, and there was no radiographic evidence of root or periapical pathosis on either tooth. The root-end of the donor tooth transplanted to the #8 site continued to develop. This case report highlights successful interdisciplinary management of two forms of root resorption using modern treatment strategies that provided immediate function and esthetics to the maxillary central incisors in a young patient following trauma.
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Affiliation(s)
- Francesc Abella Sans
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Barcelona, Spain.
| | - Nandini Suresh
- Faculty of Dentistry, Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (MAHER), TamilNadu, India
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Marc Garcia-Font
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Barcelona, Spain
| | - Adriana Gómez-Rojas
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Barcelona, Spain
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, University of Sharjah, College of Dental Medicine, Sharjah, UAE
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20
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Alharbi MA, Alghamdi BA, Alswajy WA, Kattan SA, Austah O, Othman B, Baeshen HA. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023; 24:895-901. [PMID: 38238279 DOI: 10.5005/jp-journals-10024-3566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
AIM This case report aimed to present a novel surgical technique involving orthodontics luxation of the offended tooth using miniscrew prior to performing intentional replantation (IR) to remove an extruded separated instrument that injured the inferior alveolar nerve (IAN). BACKGROUND Intentional replantation is a dental procedure that involves extracting a tooth, managing the root canal, and then reinserting the tooth back into its socket. This procedure is typically used as a last resort when other treatment options have failed or are not possible. Intentional replantation can be successful in preserving the tooth and preventing tooth loss, but it is important to note that there are risks involved. Maintaining the viability of the periodontal ligament (PDL) is a pivotal step to achieve a favorable outcome. CASE DESCRIPTION A 15-year-old female patient came to the clinic complaining of electric-like pain in the left mandibular posterior area that radiated to the left ear and sometimes caused a headache. Upon clinical and radiographic evaluation, extruded endodontic file from the mesial root of the left first molar that penetrated the IAN canal was noticed. Nonsurgical root canal retreatment was performed, which failed to retrieve the separated file. Orthodontics luxation of the offended tooth was done 2 weeks before the surgical intervention using a miniscrew to induce PDL inflammation, which increased the tooth mobility and PDL volume, facilitating the atraumatic extraction and reduced the risk of complications, such as root resorption and ankylosis. Then, IR was performed, and the extruded file was successfully retrieved. Three months follow-up showed complete recovery of the endodontics-related IAN injury symptoms. Preapical radiographic evaluation and cone-beam computed tomography scan showed complete healing of the periapical radiolucency/area of low density and complete formation of the PDL space and lamina dura around the resected roots. CONCLUSION This novel approach using a miniscrew suggests a noninvasive technique that minimizes the damage to the offended tooth surrounding tissues as well as minimizing the morbidity of the adjacent teeth and the vital anatomical structures. CLINICAL SIGNIFICANCE Multidisciplinary comprehensive preplanning of complicated cases is essential to maximize treatment efficiency. The orthodontic extrusion facilitates the extraction process that helps in preserving the PDL, and ultimately increases the survivability of the teeth. How to cite this article: Alharbi MA, Alghamdi BA, Alswajy WA, et al. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023;24(11):895-901.
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Affiliation(s)
- Mohammed A Alharbi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia, Phone: +966503653414, e-mail:
| | - Batool A Alghamdi
- Department of Endodontics, King Fahad Hospital, Ministry of Health, Almadinah, Saudi Arabia; Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Wafa A Alswajy
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Sereen A Kattan
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Obadah Austah
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Bader Othman
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Hosam A Baeshen
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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Huang J, Gan Y, Li D, Xu H, Han S, Zhu H, Jia L, Li N, Chen H, Li K, Liu Y, Cai Z. Clinical applications and outcomes of the surgical tooth extrusion technique: A bibliometric analysis from 1982 to 2023. J Prosthet Dent 2023:S0022-3913(23)00630-3. [PMID: 37852858 DOI: 10.1016/j.prosdent.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023]
Abstract
STATEMENT OF PROBLEM The surgical extrusion technique has been advocated for severely damaged teeth as well as for intruded and unerupted teeth. However, a quantitative literature analysis is lacking. PURPOSE The purpose of this bibliometric analysis was to provide a comprehensive overview of surgical extrusion, assess the applications and outcomes, and evaluate topics for future research. MATERIAL AND METHODS An electronic search was conducted in leading databases in April 2023. Human studies with surgical tooth extrusion or synonyms in titles or abstracts were included. A bibliographic analysis, co-occurrence analysis, and coupling of publications were performed. The analysis of variance was used to assess the characteristics of the subgroups based on indications. The survival rate was evaluated by using the Kaplan-Meier method in the R software program (α=.05). RESULTS Fifty-one studies from 1982 to 2023 were included. The Journal of Dental Traumatology and the Journal of Prosthetic Dentistry combined published approximately one-third of the papers and acquired the most citations. The burst detection of keywords revealed 4 popular research topics: the Benex extraction system, chlorhexidine for infection control, rigid or semi-rigid splints to decrease the risk of complications, and novel restorative materials to improve esthetics. An overall survival rate of 96.36% was reported among 316 participants with 330 extruded teeth. No significant differences were found in study types, geographic distribution, year of publication, or citation counts among the 4 subgroups (surgical extrusion for subgingival fractures, extensive caries, intruded teeth, and unerupted teeth). A significant difference was observed among the Kaplan-Meier curves of the 4 subgroups (P=.030). CONCLUSIONS Surgical extrusion may be used to save otherwise nonrestorable teeth, and the procedure has shown promising survival rates when teeth are properly selected and the procedure is well executed. Subgingival fractures and extensive caries near bone level are the predominant indications, as well as intruded and unerupted teeth. Surgical extrusion is a reliable treatment option to facilitate tooth restoration for severely damaged teeth, especially for maxillary anterior teeth.
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Affiliation(s)
- Jinwei Huang
- Attending Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yena Gan
- Graduate student, Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - Duoduo Li
- Professor, Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - He Xu
- Associate Chief Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Sheng Han
- Director, Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, PR China
| | - He Zhu
- Assistant Research Fellow, Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, PR China
| | - Lu Jia
- Lab Technician, Dental Laboratory Center, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Nan Li
- Associate Researcher, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, PR China
| | - Huimin Chen
- Associate Chief Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Kai Li
- Attending Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ying Liu
- Attending Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Zhigang Cai
- Professor, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China..
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22
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Graf T, Stimmelmayr M, Gutmann P, Güth JF, Krennmair G, Edelhoff D, Schubert O. Forced surgical extrusion using an axial tooth extraction system as a practicable technique for preserving severely destroyed teeth? - Clinical outcomes up to 4.8 years. J ESTHET RESTOR DENT 2023; 35:1152-1161. [PMID: 37096865 DOI: 10.1111/jerd.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE Several extrusion techniques have been described to restore teeth with insufficient coronal tooth structure and to avoid their extraction. Still, there is little evidence for a treatment concept combining surgical extrusion using an atraumatic axial extraction system. MATERIALS AND METHODS A total of nine patients, each with an iso- or subgingival fractured tooth, were retrospectively examined. Treatment of the damaged tooth comprised an atraumatic forced surgical extrusion performed with an axial tooth extraction system and a more coronal positioning within the socket. The teeth were initially splinted and subsequently restored. The follow-up period was up to 57.1 months and averaged 36.5 (SD: ±13.5) months. RESULTS All nine teeth were still in situ, without signs of inflammation. During the period of the provisional restoration, six prosthetic complications occurred, which were resolved with little effort, whereas, success rate for the definitive restoration was 100%. No biological complications were observed concerning the root apex or soft tissue. The radiographically measured mean extrusion distance was 3.4 (SD: ±1.0) mm, so that a sufficient prosthetic ferrule could be reestablished. CONCLUSIONS Surgical extrusions using an axial tooth extraction system demonstrate low biological and prosthetic complications rates over observation time. CLINICAL SIGNIFICANCE The presented extrusion approach preserves soft and hard tissue and is an efficient treatment option for severely destroyed teeth. Saving hopeless teeth by this relatively predictable and feasible procedure has hardly any disadvantages for patients, and in case of failure, an implant or fixed partial denture are still an option.
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Affiliation(s)
- Tobias Graf
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Pauline Gutmann
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan-Frederik Güth
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Gerald Krennmair
- Dental School, Siegmund Freud University of Vienna, Vienna, Austria
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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23
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Plotino G, Abella Sans F, Bastos JV, Nagendrababu V. Effectiveness of intentional replantation in managing teeth with apical periodontitis: A systematic review. Int Endod J 2023; 56 Suppl 3:499-509. [PMID: 35294790 DOI: 10.1111/iej.13727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Intentional replantation (IR) to treat disease of endodontic origin remains controversial. While IR has been advocated by some clinicians as another valid treatment option, others consider it as a treatment procedure of last resort. OBJECTIVE To systematically review and critically evaluate the effectiveness of IR compared with nonsurgical root canal treatment/retreatment or apical surgery in terms of clinical and patient-related outcomes in managing permanent teeth with apical periodontitis (AP). METHODS A literature search of five databases (PubMed, Embase, Scopus, Web of Science and Cochrane Central register of Controlled Trials), and the grey literature (Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, DART-Europe E-theses Portal, British Library E-Theses Online Service), from inception to November 2021, was conducted. Randomised clinical trials, comparative clinical trials (CCTs), nonrandomised, retrospective, and prospective comparative cohort and case-control two arm studies which evaluated clinical and/or patient-related outcomes of permanent teeth with AP treated with IR compared with nonsurgical root canal treatment/retreatment or apical surgery were identified. The quality of the studies was appraised using the Cochrane risk of bias tool for randomized trials (RoB 2.0), the Robins-I for nonrandomized controlled clinical trials and the Newcastle-Ottawa scale for observational studies. Two independent reviewers were involved in the literature selection, performed the data extraction and the appraisal of the studies identified; disagreements were resolved in conjunction with a third reviewer. RESULTS No comparative study was identified from the literature search. Four longitudinal studies (one prospective and three retrospective) were identified during the screening of titles and abstracts but were excluded after reading the full text, because only IR was evaluated (single arm studies). DISCUSSION The available evidence on IR is mainly based on observational studies, which reported high overall mid- to long-term survival, and low complication rates. The results suggest that IR may represent an alternative treatment procedure to solve problems of endodontic origin. However, in the absence of high-quality evidence from CCTs, clinical decision-making should be on a case-by-case basis and in accordance with the clinician's experience and the patient's preference. CONCLUSION Clinical studies showed that IR may be a treatment modality to manage problems of endodontic origin. However, clinical trials comparing the effectiveness of IR with nonsurgical root canal treatment/retreatment or apical surgery are still required given the paucity of evidence.
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Affiliation(s)
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Juliana Vilela Bastos
- Department of Restorative Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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24
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Ong DV, Goh P, Dance G. Anterior tooth autotransplantation: a case series. Aust Dent J 2023; 68:202-215. [PMID: 37415408 DOI: 10.1111/adj.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 07/08/2023]
Abstract
Tooth autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. It is relatively common for the anterior segment of the mouth to be affected by traumatic tooth injuries, impacted and/or congenitally missing permanent teeth. Autotransplantation of teeth into the anterior dental arch can provide unrivalled biological solutions when such issues arise in this critical aesthetic zone, particularly for adolescent patients. The combination of meticulous pre-surgical assessment, synergistic interdisciplinary collaboration and carefully performed anterior tooth autotransplantation has been demonstrated to achieve impressive outcomes, with respect to both transplant survival and clinical success. © 2023 Australian Dental Association.
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Affiliation(s)
- Dc-V Ong
- University of Queensland, Brisbane, Queensland, Australia
- Private Practice, Townsville, Australia
| | - P Goh
- University of Queensland, Brisbane, Queensland, Australia
| | - G Dance
- Private Practice, Townsville, Australia
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25
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Ji H, Ren L, Han J, Wang Q, Xu C, Fan Y, Zhang W, Ge X, Meng X, Yu F. Tooth autotransplantation gives teeth a second chance at life: A case series. Heliyon 2023; 9:e15336. [PMID: 37123930 PMCID: PMC10133767 DOI: 10.1016/j.heliyon.2023.e15336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/16/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
Traditional transplantation, surgical extrusion and intentional replantation procedures are important treatment options that clinicians may consider performing in their daily clinical practice. There should be a well-constructed treatment plan for teeth with problems. In this paper, we present a series of case reports on three treatment methods used in autologous tooth transplantation and a literature review on the prevention of postoperative complications and the advantages of autologous tooth transplantation compared to dental implantation. The purpose of this study was to improve the understanding of autologous tooth transplantation.
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Affiliation(s)
- Hao Ji
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
| | - Lizhi Ren
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
| | - Jiali Han
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
| | - Qianqian Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
| | - Caixia Xu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
| | - Yufeng Fan
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
| | - Wei Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
| | - Xuejun Ge
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
- Shanxi Medical University School and Hospital of Stomatology, Clinical Medical Research Center of Oral Diseases of Shanxi Province, Taiyuan 030001, China
| | - Xiaorui Meng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
- Shanxi Medical University School and Hospital of Stomatology, Clinical Medical Research Center of Oral Diseases of Shanxi Province, Taiyuan 030001, China
- Corresponding author. Shanxi Medical University School and Hospital of Stomatology, Clinical Medical Research Center of Oral Diseases of Shanxi Province, Taiyuan 030001, China.
| | - Feiyan Yu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China
- Shanxi Medical University School and Hospital of Stomatology, Clinical Medical Research Center of Oral Diseases of Shanxi Province, Taiyuan 030001, China
- Corresponding author. Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, 030001, China.
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26
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Gómez Meda R, Abella Sans F, Esquivel J, Zufía J. Autotransplantation of Maxillary Third Molar with Its Attached Buccal Cortical Plate Combined with a Connective Tissue Graft. J Endod 2023; 49:313-320. [PMID: 36623751 DOI: 10.1016/j.joen.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Tooth replacement often leads to insufficient vertical volume in the recipient socket bone. The aim of this novel report is to present a successful fully guided autotransplantation of a maxillary right third molar (tooth #1) with its attached buccal plate. The procedure was combined with a palatal connective tissue graft to reconstruct a buccal hard and soft tissue defect of an irreparable maxillary right first molar (tooth #3). METHODS A 45-year-old man complaining of pain in tooth #3 came to the clinic. Tooth #3 was non-restorable due to an extensive caries and a vertical root fracture of the mesiobuccal root, leading to a total loss of the buccal cortical plate. Guided autotransplantation of tooth #1 was completed by using 3-dimensional surgical templates for implant burs and a 3-dimensional-printed replica. After positioning the donor tooth, the cortical plate was fixed to the recipient socket with osteosynthesis screws. A connective tissue graft was also harvested to increase the band of keratinized gingiva and the thickness of the buccal soft tissue. At 6-month follow-up, the screws were removed, showing excellent regeneration throughout the buccal area. RESULTS At 3-year follow-up, the transplanted tooth was asymptomatic, with a natural bone level and no signs of replacement or inflammatory root resorption. CONCLUSIONS The use of a donor tooth and its attached bone cortical plate combined simultaneously with a connective tissue graft appears to improve hard and soft tissues in a single procedure.
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Affiliation(s)
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
| | - Jonathan Esquivel
- Louisiana State University Health Sciences Center, New Orleans, Louisiana
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27
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Albalooshy A, Duggal M, Vinall-Collier K, Drummond B, Day P. The outcomes of auto-transplanted premolars in the anterior maxilla following traumatic dental injuries. Dent Traumatol 2023. [PMID: 36740836 DOI: 10.1111/edt.12829] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS Tooth auto-transplantation is a treatment option, which is often not considered to replace anterior maxillary incisors in children and adolescents. There are multiple prognostic factors that may influence the outcomes of premolar auto-transplantation, but there is limited evidence from human studies. The aim of this study was to report the outcomes of auto-transplanted premolars in the anterior maxilla following traumatic dental injuries (TDIs) and to identify their prognostic factors. MATERIALS AND METHODS The clinical records of patients who had premolars transplanted in the anterior maxilla following TDI, with appropriate radiographs and a minimal of 1-year follow-up, were reviewed retrospectively. A specific data extraction form was developed, tested and used to collect information for the prognostic factors and outcomes. RESULTS The cohort included 120 patients with 144 auto-transplanted premolars. The mean age was 12.2 years (±2.0), and the mean observation period was 3.7 years (±1.8). The success rate was 80%, and the survival rate was 93%. Unfavourable outcomes included external replacement resorption in 12.5%, uncontrolled external inflammatory resorption in 2.7%, and both resorption types in 4.9% of teeth. Periodontal healing was significantly associated with donor tooth root maturity, graft handling at the time of surgery including ease of donor tooth extraction and placement at the recipient sites, recipient site alveolar bone status, and post-operative transplant mobility. Seventy-four teeth (53.4%) were immature at the time of transplantation where pulp revascularisation was anticipated, and 52 (70%) of those had radiographic and clinical signs of pulp healing. Pulp healing was significantly related to donor tooth eruption stage, ease of extraction of donor tooth, and ease of placement in the recipient site. CONCLUSIONS Good outcomes were observed for premolar teeth auto-transplanted in the anterior maxilla. The main prognostic factors were ease of extraction of donor tooth and ease of placement in the recipient sites and donor tooth root maturity.
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Affiliation(s)
| | - Monty Duggal
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | | | - Peter Day
- Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
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28
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Abdou A, Matoug-Elwerfelli M, Nagendrababu V, Nazzal H, Duggal M. Tooth auto-transplantation: A bibliometric analysis of the top 100 most-cited articles. Dent Traumatol 2023; 39:64-81. [PMID: 35972826 DOI: 10.1111/edt.12779] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND/AIM Tooth auto-transplantation has recently gained high clinical acceptance. The aim of this study was to identify the top 100 most-cited articles regarding tooth auto-transplantation, to analyse multiple citations and publication metrics and to outline the historical scientific advancements in this field. MATERIALS AND METHODS An advanced search of the Clarivate Analytics' Web of Science 'Core Collection' and Elsevier's Scopus databases utilising specific keywords related to tooth auto-transplantation between 1971 and 2021 was performed. The retrieved articles were ranked in descending order based on their Web of Science citation counts and further cross-matched with citation data from Scopus. The extracted data included citation counts, citation density, level of evidence, year of publication, contributing authors names and institutes, corresponding author's address, journal of publication, journal local citations index, cumulative growth index, keywords and keywords Plus. Data analysis was performed using descriptive statistics and graphical mapping. RESULTS A total of 1290 articles were retrieved. The top 100 most-cited articles received a total of 4899 (Web of Science) and 5250 (Scopus) citations. Among these, cohort studies (29%) and case series (18%) were the most common study designs. Scandinavian countries produced major contributions in defining the top 100 most-cited articles and ranked within the top 5 countries based on the number of publications and citations per year. The greatest contributing authors were Schwartz O (n = 12), Andreasen JO (n = 8) and Paulsen HU (n = 6), and they were affiliated with Copenhagen, Denmark. The top contributing journals were American Journal of Orthodontics and Dentofacial Orthopedics, International Journal of Oral and Maxillofacial Surgery, Oral Surgery Oral Medicine Oral Pathology Oral Radiology, European Journal of Orthodontics, Dental Traumatology and Journal of Oral and Maxillofacial Surgery. CONCLUSION This bibliometric analysis revealed a large geographical scientific interest and broad development in the field of tooth auto-transplantation spanning multiple dental disciplines.
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Affiliation(s)
- Ahmed Abdou
- Prosthetic Dentistry Department, Division of Biomaterials, Faculty of Dentistry, King Salman International University, El-Tur, Egypt
| | | | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hani Nazzal
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.,Dentistry Department, Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
| | - Monty Duggal
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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29
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HUANG JINWEI, GAN YENA, HAN SHENG, XU HE, YUAN YI, ZHU HE, TIAN XIA, LI NAN, LI DUODUO, CAI ZHIGANG. OUTCOMES OF AUTOTRANSPLANTED THIRD MOLARS WITH COMPLETE ROOT FORMATION: A SYSTEMIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2023; 23:101842. [DOI: 10.1016/j.jebdp.2023.101842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/25/2023] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
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30
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Bruhnke M, Beuer F, Böse MWH, Naumann M. Forced orthodontic extrusion to restore extensively damaged anterior and premolar teeth as abutments for single-crown restorations: Up to 5-year results from a pilot clinical study. J Prosthet Dent 2023; 129:61-68. [PMID: 36535882 DOI: 10.1016/j.prosdent.2022.08.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 12/23/2022]
Abstract
STATEMENT OF PROBLEM Clinical data on orthodontic extrusion to restore teeth deemed unrestorable because of their defect size are scarce. It remains unclear for which defects forced orthodontic extrusion and tooth retention is preferred to extraction. PURPOSE The purpose of this pilot clinical study was to investigate the survival, frequency, and type of complications of extensively damaged teeth requiring single-crown restorations after forced orthodontic extrusion. MATERIAL AND METHODS Participants were recruited from consecutive patients in need of restorative treatment of extensively damaged teeth at a university clinic. The teeth were orthodontically extruded to reestablish the biologic width and to ensure a 2-mm ferrule preparation before restoration. The primary endpoint was restoration success and survival. At recall, survival was defined as the tooth being in situ and success as a symptom-free tooth with an intact, caries-free restoration and with physiological pocket probing depths, no signs of intrusion, ankylosis, root resorption, or periapical radiolucency. Recalls were performed every 6 months; the outcome was assessed by radiographic and clinical evaluation after up to 5 years of clinical service. Quantitative parameters were described with mean values and standard deviations. RESULTS Thirty-four participants were assessed for eligibility and enrolled (mean ±standard deviation age: 53.4 ±18.9 years). Four participants were premature dropouts. Data were analyzed for 35 teeth in 30 participants. The amount of extrusion varied between 2 and 6 mm (mean ±standard deviation 3.4 ±0.9 mm). The mean duration of extrusion was 18.9 ±12.6 days and the mean duration of retention was 126.94 ±88.1 days. The mean ±standard deviation crown-to-root ratio after treatment was 0.8 ±0.1 (range: 0.5 to 1.0). Three participants exhibited orthodontic relapse before restoration. Teeth were successfully restored after repeated extrusion. After a mean observation period of 3.3 years (range: 1 to 5.2 years), 29 of 31 teeth were still in situ. Two teeth were fractured, and 4 participants were not available for recall. Thus, the survival rate was 94%. No resorption or periapical translucencies were observed radiographically. Clinical examinations revealed physiological probing depths and absence of ankyloses. One tooth presented with marginal bone loss. The most frequent type of complication was orthodontic relapse at recall (n=3). A total of 84% of teeth were considered a success. CONCLUSIONS Forced orthodontic extrusion allowed for the restoration of anterior and premolar teeth deemed as nonrestorable because of their defect size. Tooth retention of extensively damaged teeth and their use as abutments for single-crown restorations can be recommended.
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Affiliation(s)
- Maria Bruhnke
- Assistant Professor, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Florian Beuer
- Professor, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Mats Wernfried Heinrich Böse
- Assistant Professor, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Michael Naumann
- Professor, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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31
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Intentional Replantation of Single-Rooted and Multi-Rooted Teeth: A Systematic Review. Healthcare (Basel) 2022; 11:healthcare11010011. [PMID: 36611471 PMCID: PMC9819326 DOI: 10.3390/healthcare11010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
The technique of intentional replantation can provide a second chance to save teeth that would be destined for extraction. Therefore, the present systematic review aimed primarily to estimate tooth survival after intentional replantation and secondarily to compare treatment outcomes in single-rooted and multi-rooted teeth. The study protocol was developed before the analysis according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Articles were electronically searched in PubMed/MEDLINE, the COCHRANE library and Google Scholar by two independent reviewers, and those that met the eligibility criteria were included. A statistical analysis using the chi-square test with a p-value of <0.05 was performed on the reported outcomes of intentional replantation. A total of 44 single-rooted replanted teeth with five failures (11.36%) and 42 multi-rooted replanted teeth with six failures (14.28%) were reported in the literature, corresponding to a survival rate of 88.64% and 85.57%, respectively. The overall survival rate for the replantation procedure was 86.7%, indicating that intentional replantation can be considered a safe therapeutic choice, with no statistically significant difference between the survival rates of single-rooted and multi-rooted replanted teeth.
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32
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Algubeal HM, Alanazi AF, Arafat AS, Fatani B, Al-Omar A. Autotransplantation of the Lower Posterior Teeth: A Comprehensive Review. Cureus 2022; 14:e27875. [PMID: 36110461 PMCID: PMC9462596 DOI: 10.7759/cureus.27875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 12/25/2022] Open
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Tan D, Li ST, Feng H, Wang ZC, Wen C, Nie MH. Intentional replantation combined root resection therapy for the treatment of type III radicular groove with two roots: A case report. World J Clin Cases 2022; 10:6991-6998. [PMID: 36051153 PMCID: PMC9297402 DOI: 10.12998/wjcc.v10.i20.6991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/29/2022] [Accepted: 05/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A radicular groove is an anatomic malformation that usually initiates at the central fossa, extending along the root at varying lengths and depths and predisposes the involved tooth to a severe periodontal defect. Severe grooves that extend to the root apex often lead to complex combined periodontal-endodontic lesions. They are a serious challenge for doctors to diagnose and treat.
CASE SUMMARY In this report, we described a patient with a maxillary lateral incisor with a deep palatogingival groove with two roots, which led to complex combined periodontal-endodontic lesions. Suggested treatment modalities included curettage of the affected tissues, elimination of the groove by grinding and/or sealing with a variety of filling materials, and surgical procedures. In this case, a combination of endodontic therapy, intentional replantation, and root resection were used, which resulted in periodontal/periradicular healing after 12 mo.
CONCLUSION Intentional replantation and root resection offer a predictable procedure and should be considered a viable treatment modality for the management of palatogingival grooves, especially for two-rooted teeth.
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Affiliation(s)
- Dan Tan
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Shi-Ting Li
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Hao Feng
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Zhong-Chao Wang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Cai Wen
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Min-Hai Nie
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Plotino G, Abella Sans F, Duggal MS, Grande NM, Krastl G, Nagendrababu V, Gambarini G. Present status and future directions ‐ Surgical extrusion, intentional replantation, and tooth autotransplantation. Int Endod J 2022; 55 Suppl 3:827-842. [DOI: 10.1111/iej.13723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Gianluca Plotino
- Department of Endodontics "Sapienza" ‐ University of Rome Rome Italy
| | - Francesc Abella Sans
- Department of Endodontics Universitat Internacional de Catalunya Barcelona Spain
| | - Monty S Duggal
- Faculty of Dentistry National University Health System Singapore
| | - Nicola M Grande
- Department of Endodontics Catholic University of Sacred Heart Rome Italy
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
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Influence of Static Navigation Technique on the Accuracy of Autotransplanted Teeth in Surgically Created Sockets. J Clin Med 2022; 11:jcm11041012. [PMID: 35207285 PMCID: PMC8879114 DOI: 10.3390/jcm11041012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to analyse and compare the position of single-rooted autotransplanted teeth using computer-aided SNT drilling and conventional freehand (FT) drilling, by comparing the planned and performed position at the coronal, apical and angular level. Materials and methods: Forty single-root upper teeth were selected and distributed into the following study groups: A. Autotransplanted tooth using the computer-aided static navigation technique (SNT) (n = 20) and B. Autotransplanted tooth using the conventional free-hand technique (FT) (n = 20). Afterwards, the teeth were embedded into two experimental models and 10 single-root upper teeth were randomly autotransplanted in each experimental model. The experimental models were submitted to a preoperative cone-beam computed tomography (CBCT) scan and a digital impression by a 3D intraoral scan, in addition to a postoperative CBCT scan, after the autotransplantation. Datasets from postoperative CBCT scans of the two study groups were uploaded to the 3D implant planning software, aligned with the autotransplantation planning, and the coronal, apical and angular deviations were measured. The results were analysed using Student’s t-test and Mann–Whitney non-parametric statistical analysis. Results: Coronal (p = 0.079) and angular (p = 0.208) statistical comparisons did not present statistically significant differences; however, statistically significant differences between the apical deviation of the SNT and FT study groups (p = 0.038) were also observed. Conclusions: The computer-aided static navigation technique does not provide higher accuracy in the positioning of single-root autotransplanted teeth compared to the conventional free-hand technique.
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Selvido DI, Wongsirichat N, Arirachakaran P, Rokaya D, Wongsirichat N. Surgical Management of Impacted Lower Second Molars: A Comprehensive Review. Eur J Dent 2022; 16:465-477. [PMID: 35016240 PMCID: PMC9507580 DOI: 10.1055/s-0041-1739443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Impacted lower second molars (ILM2) are rarely reported in the literature, but various studies have been done for its treatment. Apart from solely orthodontic approaches, different surgical management techniques were reported to have successful outcomes. Surgical intervention of ILM2 can help expose the tooth for further orthodontic purposes, simplifying complex treatment methods, and reducing treatment time. This review illustrates the comprehensive evaluation and updated methods of surgical uprighting, repositioning, and transplantation of ILM2 with future directions for better understanding and treatment planning in the clinical setting. The successful outcome of surgical intervention depends on case selection, root development of ILM2, careful surgical manipulation, and adherence to sound biological principles.
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Affiliation(s)
- Diane Isabel Selvido
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Nattharin Wongsirichat
- Department of Preventive Dentistry, Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pratanporn Arirachakaran
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Dinesh Rokaya
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
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Retrospective Study of Intentional Replantation for Type Ⅲb Dens Invaginatus with Periapical Lesions. J Endod 2022; 48:329-336. [PMID: 34999093 DOI: 10.1016/j.joen.2021.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/21/2021] [Accepted: 12/31/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In recent years intentional replantation (IR) has received more attention for its high tooth survival rate and wide range of indications. Type Ⅲb dens invaginatus (DI) is one of the most serious types of tooth malformation and is very challenging to treat. When root-end surgery is not feasible, IR may be considered as an alternative to extraction. However, there is little information available on the use of IR for type Ⅲb DI. Therefore, this study investigated the treatment outcomes and clinical procedures used for treatment of type IIIb DI with IR. METHODS IR was performed to treat 10 patients with type Ⅲb DI with periapical lesions. Each tooth was examined clinically and radiologically. IR was selected by these patients as their treatment plan after treatment procedures were discussed. An experienced endodontist and an experienced surgeon performed all treatments using the same protocol and surgical technique. Postoperative assessments were comprised of clinical and radiographic examinations, tooth survival and functional status. RESULTS The follow-up period ranged from 4 to 39 months. After IR, eight teeth were functioning properly with no clinical and radiological signs of pathology. The other two teeth had complications after IR comprising recurrence of periapical radiolucency and sinus tract formation in one patient, and development of a mucosal fenestration in another. Both of these patients received additional surgery and showed marked improvements. CONCLUSION Our study evaluated the most clinical data to date and showed that IR may be a reliable alternative for type IIIb DI with a periapical lesion.
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Abella Sans F, Ribas March F, Zubizarreta-Macho Á, Boschini L, Roig Cayón M, Durán-Sindreu Terol F. Guided autotransplant of a first premolar to replace a maxillary ankylosed incisor using a custom-designed osteotome. J Am Dent Assoc 2021; 153:265-272. [PMID: 34930574 DOI: 10.1016/j.adaj.2021.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autotransplantation is a highly successful technique to replace ankylosed teeth. The authors propose a modified therapeutic approach to guide the autotransplant of an immature maxillary premolar using a tooth-shaped osteotome. CASE DESCRIPTION A 9-year-old boy reported an avulsion of his maxillary permanent left central incisor with a delayed replantation. An autotransplant of the immature maxillary right first premolar into the position of the affected tooth was planned. A surgical 3-dimensional guiding template and a tooth-shaped osteotome were manufactured to prepare the neo-alveolus (referring to the creation or modification of an alveolus to house the tooth) modification. Although the donor tooth was placed in the recipient socket with the buccal side of the root fully exposed, the transplant outcome was successful. PRACTICAL IMPLICATIONS The use of 3-dimensionally designed surgical osteotome could improve accuracy and surgical handling of a donor tooth autotransplant, even with substantial bone defects in the recipient site.
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Reichardt E, Krug R, Bornstein MM, Tomasch J, Verna C, Krastl G. Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312580. [PMID: 34886307 PMCID: PMC8656787 DOI: 10.3390/ijerph182312580] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/09/2021] [Accepted: 11/24/2021] [Indexed: 12/29/2022]
Abstract
(1) Background: To assess orthodontic forced eruption (OFE) as a pre-restorative procedure for non-restorable permanent teeth with subgingival dental hard tissue defects after dental trauma. (2) Methods: A systematic electronic search of three databases, namely, MEDLINE, Cochrane Library, and EMBASE, revealed a total of 2757 eligible publications. Randomized controlled clinical trials (RCT), retro- and prospective clinical studies, or case series (with a minimum of three patients) were reviewed. (3) Results: Thirteen full-text papers were included: one RCT, one prospective clinical trial, two retrospective cohort studies, and nine case series. Within case series, statistical significance between age and cause of fracture (p < 0.03) was determined. The mean extrusion rate of OFE was 1.5 mm a week within a four to six weeks treatment period followed by retention. Three OFE protocols for maxillary single teeth are available: 1. OFE without migration of gingiva and alveolar bone, 2. OFE with gingival migration and slight alveolar bone migration, and 3. OFE with migration of both gingiva and alveolar bone. (4) Conclusions: The current state of the evidence suggests that OFE is a feasible pre-treatment option for non-restorable permanent teeth. OFE can promote the migration of tooth surrounding hard and soft tissues in the esthetic zone. Root resorption does not seem to be a relevant side effect of OFE.
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Affiliation(s)
- Elisabeth Reichardt
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine UZB, University of Basel, Mattenstr. 40, 4058 Basel, Switzerland;
- Correspondence: or
| | - Ralf Krug
- Department of Conservative Dentistry and Periodontology, University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (R.K.); (G.K.)
| | - Michael M. Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine UZB, University of Basel, Mattenstr. 40, 4058 Basel, Switzerland;
| | - Jürgen Tomasch
- Department of Molecular Bacteriology, Helmholtz Centre for Infection Research (HZI), IInhoffenstraße 7, 38124 Braunschweig, Germany;
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine UZB, University of Basel, Mattenstr. 40, 4058 Basel, Switzerland;
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany; (R.K.); (G.K.)
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Llaquet M, Pascual A, Muñoz-Peñalver J, Abella Sans F. Periodontal and Periapical Outcomes of Surgical Extrusion: A Prospective Clinical Volumetric Study. J Endod 2021; 48:213-222. [PMID: 34848250 DOI: 10.1016/j.joen.2021.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/27/2021] [Accepted: 11/20/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Outcome predictors for the restoration of endodontically treated teeth mainly include cavity wall integrity and the presence of a 1.5-2 mm ferrule. However, in some clinical situations, the aforementioned predictors cannot be achieved. Three different techniques have been proposed to obtain an adequate ferrule respecting the supracrestal tissue attachment: surgical crown lengthening, orthodontic forced eruption, and surgical extrusion. There are little published prospective data evaluating periodontal changes after surgical extrusion. Therefore, the aims of this study were to report the outcome of surgical extrusion in single-rooted teeth, to digitally evaluate soft tissue volumetric changes after surgical extrusion, and to observe patient satisfaction regarding the treatment after a minimum of 1 year. METHODS This prospective clinical study was performed between 2017 and 2020. Thirteen patients referred for surgical extrusion met the following inclusion criteria: nonsmokers; systemically healthy with at least 1 straight, single-rooted tooth with an insufficient ferrule; a favorable tooth crown-to-root ratio, and no periodontal pathology. Preoperative clinical variables included patient age, sex and phenotype, tooth number, tooth mobility, crown-to-root ratio, gingival index (GI), probing pocket depths at 6 sites, bleeding on probing (BOP), and mesial and distal interproximal papillae volume. Surgical extrusion was performed by a single operator who completed the root canal treatment/retreatment and restored the teeth with a crown. One year later, all patients were controlled, and the following variables were recorded: tooth mobility, crown-to-root ratio, GI, pocket depth, BOP, interproximal papillae aspect, soft tissue rebound, periapical healing, marginal bone loss, and patient-reported outcome measures of the treatment. All variables were analyzed using a descriptive method (mean, %). The Wilcoxon test was used to evaluate pre- and postoperative clinical parameters at a significance level of .05. RESULTS At a mean follow-up period of 18.8 months, no teeth were extracted. Compared with preoperative GI and BOP, a significant reduction was observed at 1 year after surgery. Likewise, no significant differences in probing depths were shown, and only 1 tooth presented a type 2 mobility. The mean soft tissue rebound was -0.46 ± 0.69 mm. Overall, no significant interproximal papillae height loss was observed.Apical lesions were completely healed after surgery. The tooth crown-to-root ratio was favorable in all cases before extrusion, whereas in 3 cases it was appropriate (1 = 1), and only 1 case presented >25% of marginal bone loss during the follow-up period. The reported success rate was 92.3%, and patients were generally satisfied with the outcome. CONCLUSIONS Surgical extrusion of single-rooted teeth was successful with minimal or no soft tissue loss, and patients were satisfied with the surgical procedure and the esthetic result.
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Affiliation(s)
- Marc Llaquet
- Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Andres Pascual
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jesús Muñoz-Peñalver
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Francesc Abella Sans
- Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
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Cordaro M, Staderini E, Torsello F, Grande NM, Turchi M, Cordaro M. Orthodontic Extrusion vs. Surgical Extrusion to Rehabilitate Severely Damaged Teeth: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9530. [PMID: 34574454 PMCID: PMC8469087 DOI: 10.3390/ijerph18189530] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/29/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022]
Abstract
The need to rehabilitate severely compromised teeth is frequent in daily clinical practice. Tooth extraction and replacement with dental implant represents a common treatment choice. However, the survival rate for implants is inferior to teeth, even if severely damaged but properly treated. In order to reestablish a physiological supracrestal tissue attachment of damaged teeth and to arrange an efficient ferrule effect, three options can be considered: crown lengthening, orthodontic extrusion and surgical extrusion. Crown lengthening is considered an invasive technique that causes the removal of part of the bony support, while both orthodontic and surgical extrusion can avoid this inconvenience and can be used successfully in the treatment of severely damaged teeth. The aim of the present narrative review is to compare advantages, disadvantages, time of therapy required, contraindications and complications of both techniques.
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Affiliation(s)
- Martina Cordaro
- IRCCS, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Roma, Italy; (M.C.); (F.T.); (N.M.G.); (M.T.); (M.C.)
- Department of Orthodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Endodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Edoardo Staderini
- IRCCS, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Roma, Italy; (M.C.); (F.T.); (N.M.G.); (M.T.); (M.C.)
- Department of Orthodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Ferruccio Torsello
- IRCCS, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Roma, Italy; (M.C.); (F.T.); (N.M.G.); (M.T.); (M.C.)
- Department of Orthodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Nicola Maria Grande
- IRCCS, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Roma, Italy; (M.C.); (F.T.); (N.M.G.); (M.T.); (M.C.)
- Department of Endodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Matteo Turchi
- IRCCS, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Roma, Italy; (M.C.); (F.T.); (N.M.G.); (M.T.); (M.C.)
- Department of Orthodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Massimo Cordaro
- IRCCS, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Roma, Italy; (M.C.); (F.T.); (N.M.G.); (M.T.); (M.C.)
- Department of Orthodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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Dioguardi M, Quarta C, Sovereto D, Troiano G, Melillo M, Di Cosola M, Cazzolla AP, Laino L, Lo Muzio L. Autotransplantation of the Third Molar: A Therapeutic Alternative to the Rehabilitation of a Missing Tooth: A Scoping Review. Bioengineering (Basel) 2021; 8:120. [PMID: 34562942 PMCID: PMC8468762 DOI: 10.3390/bioengineering8090120] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Tooth autotransplantation is the repositioning of an erupted, partially erupted, or non-erupted autologous tooth from one site to another within the same individual. Several factors influence the success rate of the autotransplant, such as the stage of root development, the morphology of the tooth, the surgical procedure selected, the extraoral time, the shape of the recipient socket, the vascularity of the recipient bed, and the vitality of the cells of the periodontal ligament. The aim of this scoping review was to provide the most up-to-date information and data on the clinical principles of the third-molar autograft and thus provide clinical considerations for its success. MATERIALS AND METHODS This review was conducted based on PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). The research was conducted by searching for keywords in three databases-PubMed, Scopus and Google Scholar-by two independent reviewers following the PRISMA protocol, from which 599 records were identified. CONCLUSIONS Third-molar autotransplantation is a valid solution to replace missing teeth. The key to the success of this technique is the surgical procedure, which must be as atraumatic as possible to preserve the periodontal ligament of the tooth to be transplanted. The success rate is also linked to the stage of development of the root, with a worse prognosis in the case of a complete root.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Cristian Quarta
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Michele Melillo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy;
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
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Abella Sans F, Ribas F, Doria G, Roig M, Durán-Sindreu F. Guided tooth autotransplantation in edentulous areas post-orthodontic treatment. J ESTHET RESTOR DENT 2021; 33:685-691. [PMID: 34002459 DOI: 10.1111/jerd.12786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/24/2021] [Accepted: 05/03/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Tooth autotransplantation with a complete root formation to replace one or more lost teeth is indicated as a cost-effective alternative to implants. The aim of this case report was to describe a successfully guided autotransplantation of a maxillary third molar with fully formed roots into a surgically created socket after orthodontic space opening. CLINICAL CONSIDERATIONS A guided autotransplantation of the maxillary left third molar into the missing maxillary left first molar site was chosen. After virtually orientating donor tooth to confirm its optimum fit, it was deemed necessary to open 4 mm the mesiodistal space. Following the orthodontic movement, a 3-dimensional (3D)-guiding template and a milled surgical guide were manufactured to allow the donor tooth to be transplanted exactly in the planned position. The 2-year follow-up periapical radiograph showed a continuous periodontal space with no signs of apical periodontitis or root resorption. CONCLUSIONS Virtual planning and 3D-printed tooth replica combined with guided surgery can simplify the autotransplantation technique for both the clinician and the patient, particularly when the socket has been completely created during surgery. CLINICAL SIGNIFICANCE Virtual digital planning, which can accurately calculate the exact space to open orthodontically before an autotransplantation, could prove essential to enhancing the precision of 3D placement of the donor tooth in the recipient site.
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Affiliation(s)
- Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ferran Ribas
- Department of Oral Surgery, Private practice, Barcelona, Spain
| | - Guillermo Doria
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Miguel Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
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Plotino G, Abella Sans F, Duggal MS, Grande NM, Krastl G, Nagendrababu V, Gambarini G. European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation: European Society of Endodontology developed by. Int Endod J 2021; 54:655-659. [PMID: 33501680 DOI: 10.1111/iej.13456] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 12/25/2022]
Abstract
This European Society of Endodontology (ESE) position statement on surgical extrusion, intentional replantation and tooth autotransplantation represents the consensus of an expert committee, convened by the ESE. A narrative review in the International Endodontic Journal (Plotino et al. 2020, international Endodontic Journal, 53, 1636-52) formed the basis for the position statement. The review provided detailed information on the background, clinical procedures and the outcome of surgical extrusion, intentional replantation and tooth autotransplantation techniques. The aim of the current statement is to summarize the best available evidence on these clinical techniques to provide appropriate clinical guidance to undergraduate and postgraduate students, dental practitioners, clinical teachers and researchers. The current position statement will be updated by the ESE periodically to reflect new evidence as it becomes available to provide the most current treatment guidance for clinical practice.
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Affiliation(s)
- G Plotino
- Department of Endodontics, "Sapienza" - University of Rome, Rome, Italy
| | - F Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - M S Duggal
- Faculty of Dentistry, National University Health System, Singapore, Singapore
| | - N M Grande
- Department of Endodontics, Catholic University of Sacred Heart, Rome, Italy
| | - G Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - V Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - G Gambarini
- Department of Endodontics, "Sapienza" - University of Rome, Rome, Italy
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