Periodontal ligament repair after active splinting of replanted dogs' teeth.

Abstract

The high rate of root resorption resulting from tooth replantation represents a serious clinical problem. In order to prevent ankylosis and replacement resorption, the contemporary literature highlights the importance of using a flexible stabilization for traumatized teeth. For this purpose, orthodontic devices may be promising for obtaining a better prognosis and periodontal repair. The aim of this study was to evaluate the effect of an active splinting protocol with controlled force in dog's teeth following replantation. Sixty premolar roots from three dogs were used. They were submitted to endodontic treatment, hemisected, atraumatically extracted and subsequently replanted. They were divided into four groups: Passive Stabilization (n=20)-after 20min in a dry medium; Active Stabilization (n=20)-after 20min in a dry medium; Negative control (n=10)-immediate replantation and passive Stabilization; and Positive control (n=10)-90min of extra-alveolar time and passive Stabilization. The samples were collected and submitted to histologic processing. They were then evaluated for the count of inflammatory cells, expression of neurotrophin 4, osteoclasts, apoptotic cells and collagen fibres. The results were submitted to ANOVA or Kruskal-Wallis statistical tests followed by Tukey or Dunn post-tests (α=5%). Passive Stabilization with orthodontic brackets without traction used after replantation had the highest number of inflammatory cells (p=.0122), osteoclasts (p=.0013) and percentage of collagen fibres in the periodontal ligament (p<.0001) when compared to Active Stabilization with orthodontic brackets applying amild tensile force. Neurotrophin 4had no statistically significant difference (p=.05), regardless of the treatment. The apoptotic cells count revealed statistical differences (p<.0001) between Active Stabilization (189.70±47.99) and Positive Control (198.90±88.92) when compared to Passive Stabilization (21.19±32.94). The active splinting protocol using orthodontic appliances generating a light and controlled force favoured periodontal ligament repair of replanted teeth.