The Outcome of Contemporary Intentional Replantation: A Retrospective Study

Abstract

Introduction: Intentional replantation is a clinical procedure in which a tooth is extracted and then replanted back into its original socket after root end endodontic treatment. This procedure is typically performed as a last resort when other treatment options, such as root canal therapy or apical surgery are not feasible or have failed. The success of intentional replantation depends on several factors including the length of time the tooth was out of the socket, the condition of the root surfaces and the skills of the clinician. This retrospective case series aimed to assess the success rate of the intentional replantation procedures done in the Endodontic Department at the University of Pennsylvania and a faculty endodontic practice. Methods: Thirty teeth met the inclusion criteria. Teeth were a-traumatically extracted. All the procedures were done under high-power magnification with the use of the surgical operating microscope. Teeth were kept hydrated with Hank's Balanced Salt Solution. Contemporary root end surgery was performed on the teeth outside the socket. Retrograde preparation and filling were performed with the use of Mineral Trioxide Aggregate or Endosequence Bioceramic Putty. The outcome of IR was determined by clinical and radiographic evaluation. The cases were categorized as completely healed, healing, or failed. Results: Teeth with a minimum of 6 months follow up were included in the study. The mean follow-up period was 18 months. Twenty-two out of the thirty teeth showed complete healing, four were healing and four were considered failures. The overall success rate of the cases was 86.7% Conclusion: Despite the small sample size, our results showed that intentional replantation is a reliable and predictable procedure; when indicated, with a very high success rate if it was done correctly in a timely manner and the periodontal ligament integrity was preserved as much as possible.