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PubMed1977

[Reimplantation and autotransplantation of teeth. Review of the literature].

The most important factor for a favorable long-time prognosis of replanted and autotransplanted teeth is a short extra-alveolar periode. Implanted teeth should be followed radiographically with special attention to external resorptions as these correspond well with the histological picture. Avulsed teeth replanted within 30 minutes have a fairly good long-time prognosis. A little less than half of the teeth are still in place after five years. In international replantation the procedure can be performed with a short extraalveolar periode. By using the methods giving the shortest extraalveolar periods during autotransplantation a favorable long-time prognosis is to be expected in most of the cases. Implantation can be performed with all teeth at any developmental stage. However, a favorable long-time prognosis can only be expected where the teeth are removed from their alveoli without severe damage to the periodontal membrane. Compared to the altenative treatments which often are removable or fixed appliances or artificial implants, the prognosis for implanted teeth is sufficient good to accept the treatment as lege artis.

Animals↗

PubMed1977

Dental aspects of maxillofacial injuries.

The chief progress of maxillofacial surgery in recent years has been the preservation and the retention of functional tissue. The recent advances in microvascular and reimplantation surgery are examples. Similarly the preservation of the masticatory apparatus is best served by the retention of all viable components. Additional benefits derived from this approach include the facilitation with alignment of the bony fragments, proper occlusion of the teeth and maintenance of the vertical relationship between the upper and lower jaws; in addition to the restoration of appearance and the functions of mastication and speech. Although injuries of the teeth and their supporting stuctures at first glance may seem to be simple problems, frequently they turn out to be complicated. The most common injury is partial avulsion of the alveolar bone with loss of attached teeth, which may produce a severe defect in the jaw bone. During healing there is additional resorbtion of alveolar bone, which is quite a normal physiologic phenomenon. Therefore, the eventual defect is likely to be more severe yet. For this reason more concern should be shown for these lesser injuries.

Dentition↗

PubMed1989

Effect of tetracycline and SnF2 on root resorption in replanted incisors in dogs.

The present study was made to assess the effect of applying SnF2, tetracycline, or both, to root surfaces of extracted teeth prior to replantation. In five young adult beagles, a total of 18 mandibular incisors were extracted, bench dried for 45 min, and reimplanted in their respective sockets either after no further treatment or following treatment with 1% doxycycline HCl for 5 min, 1% SnF2 for 5 min, or 1% SnF2 followed by 1% doxycycline HCl. After 4 wk of healing, the relative frequency of root resorption (surface resorption, inflammatory resorption and replacement resorption) was approximately 27% of the root surface in bench-dried as well as in doxycycline-treated specimens. By contrast, SnF2-treated and SnF2 + doxycycline-treated teeth showed less than 1% resorption. In the latter two specimen groups an inflammatory reaction in the periodontal ligament without resorption occurred with a frequency of 38.3% and 11.1%, respectively. The results indicate that application of SnF2 to the root surface prior to replantation effectively reduces resorptive processes during the first postoperative weeks. By subsequently treating the root surface with tetracycline, the adverse effect of SnF2 on periodontal connective tissue repair may be reduced.

Animals↗

PubMed2005

Humoral immune response of patients with dental trauma and consequent replacement resorption.

Replacement dental resorption may be a consequence of trauma and may cause dental transplants or reimplants to fail. Previously, we demonstrated the participation of the immunopathological response in inflammatory dental resorption. The induction mechanisms of the two types of dental resorption are well known to be different. The aim of the present study was to observe the immune response of patients who suffered dental trauma with subsequent replacement dental resorption. Four patients with replacement radicular resorption and four healthy individuals with no evidence of radicular resorption participated in the study. The results of ELISA demonstrated that serum from patients with replacement dental resorption contained larger amounts of IgG and smaller amounts of IgM anti-total human-dentin extract and anti-fractions of extract than did serum from control individuals. These results signal the hypothesis that dentin is immunogenic and the serological profile of patients with replacement dental resorption may be identified through biochemical analysis of their blood. Precise screening by this method may allow early diagnosis of dental resorption before it becomes visible radiographically.

Adolescent↗

PubMed1990

Effect of topical application of doxycycline on pulp revascularization and periodontal healing in reimplanted monkey incisors.

Maxillary incisors in 47 monkeys, 54 in the experimental group (I) and 117 in the control group (II), were extracted and reimplanted, either immediately or after 30 or 60 min wet or dry storage. Incisors in the experimental group I were additionally kept 5 min in a suspension of 1 mg doxycycline in 20 ml physiologic saline, freshly prepared for each of the 15 animals before reimplantation. The observation time varied from 6 to 8 weeks. The teeth were removed in tissue blocks, histologically processed and evaluated for occurrence of complete pulp revascularization (CPR), presence of the micro-organisms in the pulpal lumen and ankylosis or inflammatory root resorption. Then the results were statistically evaluated, using log-linear analyses and chi-square tests (SAS, 1985) for the comparisons between group I and group II. These analyses revealed that topical application of doxycycline increased the frequency of complete pulp revascularization (P less than 0.002) and decreased the frequency of micro-organisms in the pulpal lumen (P less than 0.001). Furthermore, the frequencies of ankylosis (P less than 0.05) and inflammatory root resorption (P less than 0.001) were also decreased compared with the control group of teeth. It was concluded that the effect of topical treatment with doxycycline was most probably exerted on the micro-organisms that contaminated root surface during the extra-alveolar time; contamination of necrotic pulp tissue from the mechanical damage in the cervical part of the root surface was not affected.

Animals↗

PubMed2000

Pulp revascularization of replanted immature dog teeth after different treatment methods.

The purpose of the present study was to determine the effect of topical treatment with doxycycline and/or the application of unfilled resin to the anatomical crown on the occurrence of revascularization in reimplanted dog teeth. Ninety-six teeth in 4 young mongrel dogs were used. Eighty one teeth were atraumatically extracted and divided into four groups. Group 1, 17 teeth were kept dry for 5 min and then replanted. Group 2, 21 teeth were soaked with a freshly prepared solution of doxycycline (1 mg/20 mL saline) for 5 min before replantation. Group 3, 23 teeth were soaked with the doxycycline solution for 5 min, and then replanted. The crowns were coated with 2 layers of light cured unfilled resin. Group 4, 20 teeth were kept dry for 5 min, and then replanted. The crowns were treated as with the teeth in Group 3. Three months after surgery, radiographic evaluation revealed that 27 teeth had continued root development and 32 teeth showed arrested root development with periradicular pathosis. The remaining 17 teeth, which had arrested root development but no signs of periradicular pathosis, were all histologically evaluated for final assessment. The occurrence of revascularization according to treatment group was 29.4%, 60%, 60%, 36.8% in Group 1, 2, 3, and 4, respectively. A multiple logistic regression analysis in SAS indicated there was no significant association between vitality and dog (P = 0.7564). Soaking for 5 min in doxycycline significantly increased the revascularization rate (P = 0.024) while the addition of resin to the crown did not result in an increased incidence of pulp revascularization (P = 0.823).

Administration, Topical↗

PubMed1984

Potentials for root resorption during periodontal wound healing.

The present study was undertaken to examine whether (1) the process of resorption, which invariably affects periodontitis involved reimplanted roots facing bone or gingival connective tissue during healing, is a transient phenomenon and, (2) root resorption can be prevented by permitting downgrowth of epithelium along the root surface. A total of 24 teeth in 2 monkeys (Macaca cynomolgus) was subjected to experimental periodontal tissue breakdown by the placement of elastic ligatures around the teeth. The ligatures were left in situ until about 50% of the supporting tissues had been lost. Following removal of the ligatures, the teeth were extracted and the denuded portions of the roots were scaled and planed. The crowns of the teeth were resected and the root canals filled with guttapercha. The roots were subsequently implanted into sockets prepared in the jaw bone in such a way that each root was embedded in bone except for a portion which was in contact with gingival connective tissue. 1 month prior to sacrifice of the animals, the cut surface of the coronal part of the roots was exposed by removal of the covering soft tissue. The epithelium was thereby allowed to migrate into the wound. Implantation of the roots was scheduled to provide healing periods of 1, 2, 3, 4, 8, 12, 16, 20 and 24 weeks before exposure of the roots. The histologic examination of the implant specimens disclosed that replacement resorption was a progressive process which eventually resulted in the elimination of the transplanted roots. It was possible to prevent root resorption in this model by permitting apical downgrowth of epithelium along the root surface during the initial phase of healing. The results are discussed in relation to procedures used in periodontal therapy.

Animals↗