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PubMed1989

Twelve-year follow-up of a replanted incisor.

A case report with a 12-yr follow-up of a replanted maxillary incisor is presented. A maxillary incisor, #8, with incomplete root formation was replanted without splinting following a 2-h sojourn in salt water. The pulp responded positively to the electric pulp tester for 2 yr. There was no response to the electric pulp tester 5 yr postoperatively. Although there was some external root resorption, the root appeared to have reached normal length. Two parallel vertical radiolucent slits were present in a trabeculated substance in the site normally occupied by the pulp. This case illustrates an example of revascularization and pulp obliteration. Interestingly, at the 12-yr follow-up, the replanted tooth, as well as tooth 7, showed blunted apices that occurred following orthodontic tooth movement.

Child↗
PubMed1990

Cell renewal and ground substance formation in replanted cat teeth.

The cellular dynamic pattern of pulpal healing 4, 10, 30, and 60 days after replantation of 47 apicoectomized cat incisors was studied after pulse labeling with 3H-thymidine and 35S-sulfate, autoradiography, and routine histology. In the control teeth the labeling index was less than 0.05%. The apical pulpal cells were capable of ground substance formation and cell proliferation already 4 days after replantation, with a labeling index of 7%, which increased up to 43% within 10 days. A gradual postoperative restitution and reorganization within the pulpal cellular compartment was seen. The maximum cell density, reached after 30 days, was reduced to on average 60% compared with the controls. The tissue reorganization was near completion within all pulpal zones after 60 days, and the labeling index was reduced to 2.5%. In some instances internal resorption in cervical pulpal areas negatively influenced the favorable healing. The present study shows that the pulpal healing in replanted teeth follows a consistent basic pattern in cellular dynamics and in histologic changes. The replanted tooth thus seems to be a suitable model for studies of healing and repair in connective tissues.

Animals↗
PubMed1997

Suture splint: an alternative for luxation injuries of teeth in pediatric patients--a case report.

Stabilization of replanted tooth "splinting" is done to prevent further damage to the pulp and periodontal structure during the healing period. Suture and bonded resin splint is passive, semirigid and functional splint. It is easy to fabricate directly in mouth without lengthy laboratory procedures. A case is presented in which suture and bonded resin splint was performed on laterally luxated maxillary central incisor and avulsed lateral incisor. The splint was removed after one week and sufficient periodontal and gingival healing was observed.

Adolescent↗
PubMed1989

Progression of root resorption following replantation of human teeth after extended extraoral storage.

Avulsed human permanent teeth subjected to a minimum of 1 h dry extraoral storage before replantation were followed radiographically for an average of 4.8 years. The depth of root resorption cavities was assessed using a radiographic index, and the rate of root resorption was defined as the index change over time. The frequency of inflammatory and replacement resorption was determined at each observation time. Replacement resorption increased in frequency with time in all patients. In teeth endodontically treated within 3 weeks of replantation, minimal inflammatory resorption was found regardless of the age of the patients. In teeth where endodontic treatment was performed more than 3 weeks after replantation, the frequency of inflammatory resorption was significantly higher in young patients but not in older patients, up to more than 3 years after replantation. The rate of root resorption was found to be related to age. In patients 8-16 years old at the time of avulsion the rate of root resorption was significantly higher compared with patients 17-39 years old. Age had a higher impact on the rate of root resorption compared with the delay in endodontic treatment after replantation. It was concluded that a tooth replanted with a necrotic periodontal membrane will become ankylosed and resorbed within 3-7 years in young patients, whereas a tooth replanted under similar conditions in older patients may remain in function for a considerably longer time.

Adolescent↗
PubMed1982

Unusual cervical resorption after reinjury.

The root canal of a maxillary central incisor apparently completely calcified after an injury. Eight years later, this tooth was injured again and massive resorption developed. The resorption began as an unusual pattern of cervical destruction, and ultimately the entire root apparently was destroyed. However, the tooth was still serving satisfactorily without other symptoms seven years after the reinjury--15 years after the original injury. Calcification of the pulp space can develop in a tooth and the root structure can be resorbed in a tooth after an injury. Therefore a similar stimulus can produce opposite responses, in this instance in the same tooth at different times. Luxation of teeth is a treatable injury, and replantation of luxated teeth is an acceptable technique that can result in long-term retention of the replanted tooth. Replantation of the patient's own tooth is usually preferred to artificial replacement of the luxated tooth at the time of injury. Interceptive endodontic care for a tooth that has been traumatized and in which the pulp space appears on the radiograph to be calcifying is probably best for the patient.

Adolescent↗
PubMed1992

Intentional replantation of a removable partial denture abutment tooth: a case report.

Intentional tooth replantation is a last-resort procedure, recommended only when all other techniques, short of tooth extraction, have been exhausted or are impractical. Although most endodontic textbooks describe the procedure, and many reports of intentional replantation have appeared in the dental literature, none have reported use of the technique to retain a removable partial denture abutment tooth. This article presents such a case and the rationale for the decision to intentionally replant. Eighteen-month follow-up clinical and radiographic results are presented.

Bicuspid↗
PubMed1997

Timing of extraction of ankylosed teeth to maximize ridge development.

Retaining an ankylosed replanted tooth during jaw growth leads to arrested development of the associated alveolar ridge. As the adjacent teeth erupt and the adjacent alveolar ridge develops, the ankylosed tooth is left in infraocclusion. The severity of the resulting ridge defect depends on the amount of facial growth after ankylosis. The extent of the defect correlates with the length of time an ankylosed tooth is retained during adolescent rapid growth. This case report illustrates the development of an extensive alveolar ridge defect when a replanted tooth became ankylosed and was allowed to remain through an adolescent growth spurt. The change in tooth position is dramatic and reflects the marked difference in ridge development. Clinical guidelines are presented to determine the optimal timing of extraction of ankylosed teeth to maximize alveolar ridge development.

Adolescent↗
PubMed2000

Responses of immunocompetent cells in the dental pulp to replantation during the regeneration process in rat molars.

Responses of immunocompetent cells to tooth replantation during the regeneration process of the dental pulp in rat molars were investigated by immunocytochemistry using antibodies to class II major histocompatibility complex (MHC) molecules (OX6 antibody), monocyte/macrophage lineage cells (ED1 antibody) and protein gene product 9.5 (PGP 9.5), as well as by histochemical reaction for periodic acid-Schiff (PAS). Tooth replantation caused an increase in both the number of OX6- and ED1-positive cells and their immunointensity in the replanted pulp, but almost all PGP 9.5-immunoreactive nerves diminished in the initial stages. By postoperative day 3, many OX6- and ED -immunopositive cells had accumulated along the pulp-dentin border to extend their cytoplasmic processes into the dentinal tubules in successful cases. Once reparative dentin formation had begun after postoperative day 7, OX6- and ED1-immmunopositive cells became scattered in the odontoblast layer, while reinnervation was found in the coronal pulp. The temporal appearance of these immunocompetent cells at the pulp-dentin border suggests their participation in odontoblast differentiation as well as in initial defense reactions during the pulpal regeneration process. On postoperative day 14, the replanted pulp showed three regeneration patterns: (1) reparative dentin, (2) bone-like tissue formation, and (3) an intermediate form between these. In all cases, PAS-reactive cells such as polymorphonuclear leukocytes (PML) and mesenchymal cells occurred in the pulp space. However, the prolonged stagnation of inflammatory cells was also discernible in the latter two cases. Thus, the findings on PAS reaction suggest that the migration of the dental follicle-derived cells into the pulp space and the subsequent total death of the proper pulpal cells are decisive factors for eliciting bone-like tissue formation in the replanted pulp.

Animals↗
PubMed1981

Repair processes in the cervical region of replanted and transplanted teeth in monkeys.

The repair processes in the cervical region of replanted teeth where the periodontal ligament was injured by either extensive drying or removal was studied. These repair processes were related to various clinical factors, such as splinting, traumatic occlusion and exactness of repositioning. Permanent incisors were extracted, root filled extraorally and allotted to the following experimental groups: (1) PDL injured by drying, no splinting; (2) PDL injured by drying, splinting for 2 weeks; (3) PDL injured by drying, replanted tooth in traumatic occlusion; (4) PDL injured by drying, no splinting, non-exact repositioning of the replanted tooth; (5) PDL removed, no splinting. The animals were sacrificed 8 weeks after replantation and the replanted teeth examined histometrically. The different groups demonstrated area with normal periodontal ligament extending from 0.4 to 1 mm apically from the crestal margin, where the greatest extent was found in teeth with non-exact repositioning. The possible role of the gingiva in these repair processes is discussed.

Animals↗
PubMed1981

The effect of excessive occlusal trauma upon periodontal healing after replantation of mature permanent incisors in monkeys.

The effect of excessive occlusal force upon periodontal healing after replantation of mature permanent incisors was studied in green Vervet monkeys. The extra-alveolar period before replantation was 120 min. Prior to replantation, the teeth were root filled with gutta percha. The material consisted of four groups. In the two control groups, either no splinting or splinting for 2 weeks was used. In the first experimental group, a stainless steel crown was cemented on the antagonist of the replanted tooth, thus elevating the bite 1--2 mm. In the second experimental group, an orthodontic band was cemented onto the replanted tooth, also elevating the bite slightly. All bite elevations were removed after 6 weeks. The animals were sacrificed 8 weeks after replantation and the replanted teeth were examined histometrically. Replacement resorption (ankylosis) was found with the same frequency and extent in all groups. However, a significant difference was found in the pattern of replacement resorption activity among the experimental groups. Thus, active replacement resorption was more common in the groups with no splinting or traumatic occlusion as compared to the splinted group. Furthermore, linear replacement resorption, a process which apparently removes established ankylosis areas, was significantly more frequent in the non-splinted groups than in the other groups. It is concluded that excessive occlusal forces cannot prevent or eliminate ankylosis in replanted teeth after prolonged extra-alveolar dry storage.

Animals↗
PubMed2003

Possible role of immunocompetent cells and the expression of heat shock protein-25 in the process of pulpal regeneration after tooth injury in rat molars.

Recent studies have established that heat shock proteins (HSPs) potentially play a role in immunosurveillance. The purpose of the present study was to clarify the relationship between the chronological changes of immunocompetent cells and the expression of HSP-25 in the process of pulpal regeneration after tooth injury in rat molars by immunocytochemistry for HSP-25 and class II major histocompatibility complex (MHC) antigen. In untreated control teeth, intense HSP-25 immunoreactivity was found in the cell bodies of odontoblasts. Both cavity preparation and tooth replantation caused the degeneration of the odontoblast layer to result in the loss of HSP-25 immunoreactions in the suffered dental pulp at the early stages after tooth injury. Numerous class II MHC-positive cells appeared along the pulp-dentin border and extended their cell processes into the dentinal tubules at 12-24 h after cavity preparation and 3 days after tooth replantation. Newly differentiated odontoblast-like cells with HSP-25 immunoreactivity were arranged at the pulp-dentin border and the class II MHC-positive cells retreated towards the subodontoblastic layer by post-operative days 3-5 after tooth injury. Thus, the common cellular events occur during pulpal regeneration following two different experimental injuries. These findings indicate that the time course of changes in the expression of HSP-25 immunoreactivity reflects the degeneration/regeneration process of odontoblasts and that the temporal appearance of the class II MHC-positive cells at the pulp-dentin border suggests their participation in odontoblast differentiation as well as in initial defence reactions during the pulpal regeneration process.

Animals↗
PubMed1993

Dental tissues involved in exarticulation, root resorption and factors influencing prognosis in relation to replanted teeth. A review.

Prognosis in relation to an exarticulated, replanted tooth is poor. Late complications are frequent and often lead to tooth loss. However, the root of a replanted, avulsed tooth may be slowly resorbed preserving alveolar width and postpones replacement of the tooth to a more convenient time. During healing following transplantation or replantation of teeth, various dental and oral structures are involved. Late complications relate to various factors. Tissues and factors involved are reviewed. Knowledge of this subject derives mostly from results of transplantation studies in animals.

Humans↗
PubMedDate not supplied

[Dental replantation].

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Tooth Replantation↗