Mahmoud Torabinejad, DMD, MSD, PhD, Nathan A. Dinsbach, DDS, MSD, Michael Turman, DDS, MSD, Robert Handysides, DDS, Khaled Bahjri, MD, MPH, and Shane N. White, BDentSc, MS, MA, PhD
Context
- Nonsurgical root canal treatment (NSRCT) provides high long-term survival and success rates (1–4), allowing millions of people to preserve their natural dentitions.
- Although nonsurgical initial root canal treatment and retreatment have high success rates, periapical disease can remain (5–7). Additionally, successfully treated teeth can become re-infected through coronal micro-leakage after a period of health (8).
- When a tooth has been non-surgically retreated and disease persists, options include no treatment; extraction and replacement using a single-tooth implant, a fixed dental prosthesis, or a removable dental prosthesis; apical microsurgery; and intentional replantation and auto-transplantation.
- Intentional replantation is often considered to be a procedure of last resort (19, 20), likely because of the wide variance in reported success rates and the absence of an established protocol (21).
- Knowing the prognosis for intentionally replanted (IR) teeth would assist patients and dentists in making decisions, particularly in choosing between 2 surgical approaches: tooth retention through intentional replantation or tooth replacement using an ISC (22–27).
- ISC treatment has advanced rapidly over the last 2 decades and is now the treatment of choice when replacing missing teeth (3, 4). However, comparisons between the outcomes of intentional replantation and ISC could not be identified.
Purpose of the Review
To examine the literature and quantify and compare the survival of IR natural teeth with that of contemporary ISCs.
Key Findings
- The mean survival of ISCs (97%) was significantly higher than that of IR teeth (88%).
- One study indicated that orthodontic extrusion of a tooth before intentional replantation decreased the risk of resorption and increased the survival. This most recent intentional replantation study using contemporary materials reported high survival.
References