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Retention and Healing Outcomes after Intentional Replantation

 Sin-Yeon Cho  ;  Yoon Lee  ;  Su-Jung Shin  ;  Euiseong Kim  ;  Il-Young Jung  ;  Shimon Friedman  ;  Seung-Jong Lee 
 JOURNAL OF ENDODONTICS, Vol.42(6) : 909-915, 2016 
Journal Title
Issue Date
Adult ; Aftercare ; Ankylosis ; Female ; Humans ; Male ; Patient Outcome Assessment ; Periapical Periodontitis/etiology ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea ; Root Resorption/etiology ; Survival Analysis ; Time Factors ; Tooth Diseases/etiology ; Tooth Extraction ; Tooth Replantation/adverse effects ; Tooth Replantation/methods* ; Tooth Replantation/statistics & numerical data* ; Tooth Root ; Treatment Outcome* ; Wound Healing
Extraoral time ; healing outcome ; intentional replantation ; survival rate
INTRODUCTION: Intentional replantation is an alternative to tooth extraction and prosthetic replacement when conventional endodontic treatment modalities are unfeasible or contraindicated. This study assessed tooth retention and healing after intentional replantation and explored predictors of these outcomes.
METHODS: Data of intentional replantation procedures performed between March 2000 and December 2010 were collected prospectively, excluding teeth with preoperative periodontal and root defects. A cohort of 159 teeth was followed up for 0.5-12 years. Retention and healed status without complications (periapical radiolucency, external root resorption, ankylosis, signs/symptoms, probing ≥6 mm) was recorded and analyzed with Kaplan-Meier survival analysis and Cox proportional hazard regression model (P < .05).
RESULTS: Complications leading to extraction occurred in 8 of 159 teeth (5%). Kaplan-Meier survival function suggested 93% cumulative 12-year retention. Cumulative healed rates declined from 91% at 6 months to 77% at 3 years. The healed rate was significantly lower for maxillary teeth without preoperative periapical radiolucency, replanted in more than 15 minutes, and root-end filled with ProRoot MTA. Cox regression identified extraoral time ≤15 minutes as predictor of complication-free healing (P < .04; hazard ratio, 2.767; 95% confidence interval, 1.053-7.272).
CONCLUSIONS: This prospective cohort study of contemporary intentional replantation suggested a cumulative 12-year retention rate of 93% and healed rate of 77% after 3 years. Healing occurred 1.7 times more frequently in teeth replanted within 15 minutes. Although most complications occurred within 1 year after replantation, follow-up should extend for at least 3 years to capture late complications.
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2. College of Dentistry (치과대학) > Dept. of Conservative Dentistry (보존과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eui Seong(김의성) ORCID logo https://orcid.org/0000-0003-2126-4761
Shin, Su Jung(신수정) ORCID logo https://orcid.org/0000-0001-5795-3919
Lee, Seung Jong(이승종)
Jung, Il Young(정일영) ORCID logo https://orcid.org/0000-0001-8972-2664
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