Delayed Tooth Replantation Research Articles

Delayed tooth replantation after traumatic avulsion of a maxillary incisor: A case report

Delayed tooth replantation after traumatic avulsion of a maxillary incisor: A case report

Evaluation of calcium hydroxide mixed with propolis by ultrasonic activation as root canal dressing in delayed tooth replantation.

In cases of tooth avulsion, in which the neurovascular bundle responsible for nourishing the dental pulp is break, endodontic treatment is necessary before proceeding with tooth replantation. In this process, various substances have been tested in combination with calcium hydroxide Ca(OH)2 in an attempt to improve its effectiveness. This study aimed to examine the effects of using a mixture of Ca(OH)2 and 10% propolis, with subsequent application of ultrasonic treatment, on the delayed replantation of teeth in rats. Twenty-four rats underwent a surgical procedure to extract the upper right incisor, leaving it on a surface to dry for one hour. The pulp and periodontal ligament were removed and the teeth were submerged in a 2% sodium fluoride acidulated phosphate solution. The canals were dehydrated using paper cones and the teeth were divided into four groups, according to the type of intracanal dressing: Ca(OH)2 group, Ca(OH)2 group with ultrasonic agitation, Ca(OH)2 and propolis group, Ca(OH)2 and propolis group with ultrasonic agitation. The root canals were irrigated with saline solution and the teeth were reimplanted. Sixty days after reimplantation, the animals were euthanized. With regard to the presence of acute and chronic inflammatory infiltrate in the periodontal ligament, there was no statistically significant difference among some of the groups. Root resorption was identified in all groups, and there was no significant difference between them. It is concluded that the application of intracanal dressing containing Ca(OH)2 associated with 10% propolis, followed by ultrasonic agitation, did not prove to be more effective than the use of Ca(OH)2 alone in the repair process in the delayed replantation of rat teeth. Key words:Tooth replantation, Calcium hydroxide, Propolis, Ultrasound, Intracanal dressing.

Effect of intra-alveolar delivery of Frondoside A on inflammatory response of delayed tooth replantation.

Frondoside A is a sea cucumber extract which is well known for its anti-inflammatory and immunomodulatory properties. The purpose of this study was to evaluate the effect of Frondoside A application in the alveolar socket on inflammatory responses after delayed replantation in rat teeth. Human periodontal ligament cells were cultured and exposed to Frondoside A. Cell-counting kit-8 assay was performed to evaluate the cell viability and nitric oxide assay was performed to assess the anti-inflammatory effect of Frondoside A. Molars were extracted from 32 Sprague-Dawley rats and randomly divided into control and Frondoside A groups. After 30 min of extra-oral dry time, molars were replanted. In the Frondoside A group, Frondoside A solution was applied in the alveolar socket before replantation. The animals were sacrificed after 28 days and histologically and immunohistochemically evaluated. 0.5 μM Frondoside A showed higher cellular viability at 6 h and lower production of nitric oxide compared with other Frondoside A solutions (p < .05). The Frondoside A group demonstrated lower inflammatory resorption scores in both middle 1/3 and apical 1/3 of root compared to the control group (p < .05). The Frondoside A group showed lower levels of expression in both cathepsin K and CD45 compared with the control group (p < .05). Within the limits of this study, intra-alveolar delivery of Frondoside A alleviates inflammatory root resorption in delayed replantation of rat teeth.

The impact of platelet-rich fibrin (PRF) on delayed tooth replantation: A preliminary animal study.

The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF) placed in delayed replantation of mature extracted teeth. Sixteen intentionally extracted teeth in two mature beagle dogs were selected. In one quadrant of each jaw, the extraction sockets were filled with PRF prior to replantation, and the other quadrant served as control without PRF. All extracted teeth underwent endodontic treatment and dried for 60 min. Thereafter, they were replanted with a flexible splint. After 8 weeks, the animals were euthanised, and the histological sections examined. Less inflammatory root resorption was noted in the PRF group compared to the control (P = 0.031). However, there was no significant difference between the two groups with regard to new bone formation, inflammatory status, connective tissue healing and replacement resorption (P > 0.05). Using PRF in the extracted socket before delayed replantation did not provide any significant benefit other than reduced inflammatory root resorption.

Effect of root surface treatment with denusomab after delayed tooth replantation.

To evaluate denosumab, a human monoclonal antibody that mimics the effects of osteoprotegerin in bone metabolism, as a topical treatment of root surface to be used prior to delayed tooth replantation. Thirty-six rats' right incisors were used. Teeth were extracted and divided into: delayed replantation without root surface treatment (control); delayed replantation with root surface treatment with denosumab 60mg/mL and 30mg/mL, respectively, for 10min both experimentals groups. After that, the root canals were filled with calcium hydroxide and replanted. After 15 and 60days, the animals were euthanized, and the samples were collected and processed for microscopic analysis. Histological sections were performed, and stained with HE to describe the dental characteristics, measure ankylosis, replacement resorption, and dental resorption by conventional microscopy. Also, was performed Brown & Brenn staining and immunohistochemistry for RANKL, OPG, and periostin. Denosumab 60mg/mL reducted ankylosis (p < 0.0001), replacement resorption (p < 0.0001), and tooth resorption, 60days after replantation, compared to untreated replanted teeth (p < 0.005). Lower bacterial contamination in root surface in the denosumab treatment groups was found, regardless of the concentration used (p < 0.001). Also, denosumab treatment inhibited the expression of RANKL without modulating OPG. Periostin was observed in periodontal ligament of replanted tooth, although this labelling was absent in the ankylosis areas, in both experimental periods. Treatment of the root surface with denosumab at 60mg/mL of rat teeth before delayed replantation reduced dental root resorption compared with the untreated teeth after 60days. Survival of a replanted tooth has been a challenge in clinical practice. The use of a medication, such as denosumab, to limit dental root resorption represents an important therapeutical approach.

Influence of anti-allergic drugs used systemically on the process of root resorption during delayed tooth replantation: A study in rats.

Anti-allergic drugs can inhibit the hard tissue resorption process, and due to similarities between root resorption and bone mechanisms, it can be inferred that these drugs may also control root resorption. The aim of this study was to analyze the effects of anti-allergic drugs used systemically on the process of root resorption following delayed tooth replantation. Thirty-two maxillary right incisors of rats were extracted and subsequently replanted. Rats were divided into four groups according to the anti-allergic drug administered: the rats in groups DEX, Q, and MO were treated systemically with dexamethasone phosphate, quercetin, and montelukast, respectively, and no systemic medication was administered to rats in group C. After 60days, the animals were euthanized, and the specimens were processed for histomorphometric and immunohistochemical analyses. Statistical significance was set at P<.05. There were no significant differences between the groups in terms of inflammatory resorption, replacement resorption, or presence of tartrate-resistant acid phosphatase. In terms of events occurring in the periodontal ligament space, there was a difference between groups Q and MO due to the presence of dental ankylosis and inflammatory connective tissue (P<.05). A difference in inflammatory cells was also observed through CD45 immunolabeling between the DEX and Q groups when compared to the C group (P<.05). The systemic administration of anti-allergic drugs did not have an effect on the process of root resorption following delayed tooth replantation.

Delayed Tooth Replantation after Root Surface Treatment with Papain and Sodium Fluoride in Rats: A Histological and Histomorphometrical Evaluation.

The aim of this study was to examine the histological effect of papain and sodium fluoride in delayed replantation of rat incisor teeth on the repair process. Forty upper incisors of Wistar rats were randomly assigned to four groups (n=10). In group I, the dental papilla and the pulp tissue of extracted teeth were removed before immediate replantation in their sockets. In the other groups, the extracted teeth were maintained in dry storage for 60 min and subjected to different root surface treatments. In group II, the teeth were immersed in 10% papain for 20 min, scrubbed with gauze soaked in saline for 1 min, and immersed in a 2% acidulated-phosphate sodium fluoride solution for 20 min. In group III, the teeth were immersed in saline for 20 min, scrubbed with gauze soaked in saline for 1 min, and immersed in a 2% acidulated-phosphate sodium fluoride solution for 20 min. In group IV, root surface treatment was not applied. The root canals were treated and filled with a calcium hydroxide paste and the teeth were replanted. The animals were euthanized after 60 days and anatomic specimens containing the teeth were subjected to routine histochemical processing and staining with hematoxylin and eosin. The Kruskal-Wallis test was used, followed by the Dunn's test for multiple comparisons. Groups I and II had less inflammatory root resorption and total area of root resorption (P<0.05) than groups III and IV respectively. Based on this animal study, root surface treatment with papain and sodium fluoride in delayed tooth replantation showed greater efficacy in controlling inflammatory root resorption and may be a viable option for clinical application.

ROOT SURFACE TREATMENT USING DIODE LASER IN TOOTH REPLANTATION (EXPERIMENTAL STUDY IN RATS)

INTRODUCTION: Avulsion of teeth radically affects the integrity of the tooth and the supporting tissue, and impairs the natural dentition as a whole; thus, all efforts must be directed to the replantation of traumatically avulsed teeth. However, its success is limited due to the occurrence of external root resorption. The challenge is to follow an effective protocol that reduces the occurrence of root resorption and allow for reestablishment of the natural architecture of the periodontal tissue. Biomodulation provided by low level laser therapy provides a promising tool in managing the inflammatory process and augmentation of the reparative process. OBJECTIVES: Was to evaluate the effect of low-level laser therapy (LLLT) on the healing process of rat teeth replanted after delayed replantation. MATERIALS AND METHODS: Thirty healthy Albino male rats had their maxillary left incisors extracted; According to the root surface treatment before the replantation, the teeth were assigned randomly to two groups (n = 15): G1 (control) – no root surface treatment; G2 (study group)-laser diode treatment on the root surface. The teeth were replanted into their respective sockets after 30 minutes, mimicking the natural timing it would take to replant an avulsed tooth. G2 were treated with LLLT performed on the buccal and palatal mucosa every 48 hours for 15 days. The rats were sacrificed after 15, 30 and 45 days of replantation. The specimens were processed for histological and histomorphometric analysis to determine the average root resorption areas and to evaluate the histological events. RESULTS: Histomorphometric analysis showed that the study group (Laser irradiated group) showed lower areas of root resorption and ankylosis, than in control group (non-irradiated group); with a significant statistical difference (p > 0.05). Histological assessment showed restoration of periodontal ligament attachment and increased vascularity in the study group. CONCLUSIONS: Laser irradiation reduces external root resorption and ankylosis in delayed tooth replantation.

The effect of cathepsin K inhibitor surface treatment on delayed tooth replantation in dogs.

Continuous research efforts have been focusing on promoting healing of delayed replantation of avulsed teeth. The aim of this in vivo study was to assess the effect of cathepsin K inhibitor surface treatment on delayed tooth replantation. Thirty-four premolar roots of 4 beagle dogs were extracted, and conventional root canal treatment was performed. The canals were filled with gutta-percha and cement. All extracted teeth were air-dried for 1hour. Teeth were divided into 2 groups according to the root surface treatment prior to replantation: control (n=13) and cathepsin K inhibitor (n=21). Treated teeth were replanted in their original sockets and stabilized with a resin-wire splint for 1week. After 12weeks, the dogs were euthanized and micro-computed tomography was performed. Tissues were then further processed as resin-embedded specimens stained with hematoxylin and eosin. In each evaluation, data were analyzed using the Mann-Whitney U test (P<.05). In the micro-computed tomography evaluation, inflammation scores of both groups were not statistically different (P>.05). In the histological evaluation, the mean proportions of inflammatory resorption and replacement resorption in the control group were similar to those in the cathepsin K inhibitor group (P>.05). Cathepsin K inhibitor did not demonstrate significant inhibitory effects on root resorption after delayed replantation in vivo.

Laser phototherapy induces angiogenesis in the periodontal tissue after delayed tooth replantation in rats.

BackgroundLaser phototherapy (LPT) has been suggested as a new therapeutic tool to improve the repair of replanted teeth. However, its effects and mechanism of action are not yet completely understood.ObjectivesThis study evaluated histologically the effect of laser phototherapy (LPT) λ808 and λ660 nm on angiogenesis in the periodontal tissue of replanted teeth in rats.Material and MethodsTwenty maxillary right incisors were extracted from twenty Wistar rats and randomly assigned to four groups (n = 5): PN – teeth were stored in paper napkin for 45 min; WM – teeth were immersed in 20 ml of UHT whole cow milk for 45 min; PNL and WML – teeth received the same treatment described for PN and WM, respectively, plus LPT at λ808 and λ660 nm. All root canals were prepared and filled with calcium hydroxide paste. The animals were euthanized 15 days after tooth replantation and angiogenesis was scored by blood vessel counting in the area of periodontal ligament and alveolar bone, using the ImageJ software. Data were analyzed statistically by ANOVA and Tukey’s test (α = 5%).ResultsLPT at λ808 and λ660 nm caused significant increased angiogenesis on irradiated groups (PNL and WML) when compared to the non-irradiated groups (PN and WM) (p<0.05). There was no statistically significant difference between PN and WM as well as between PNL and WML (p>0.05).ConclusionsLPT is capable of stimulating angiogenesis in vivo in the periodontal tissue of replanted teeth. Key words:Angiogenesis, lasers, tooth avulsion, tooth replantation, wound healing.

Stem Cells from Human Exfoliated Deciduous Teeth in Delayed Tooth Replantation: Histologic and Histomorfometric Analyses in Rats

Aim: The complication in delayed replantation is root resorption that leads to loss of reimplanted teeth. This study was designed to evaluate the influence of stem cells from human exfoliated deciduous teeth (SHEDs) on the healing process of periodontal tissues after delayed tooth replantation in rats. Material and Methods: Forty-five rats had their right upper incisor extracted and maintained in dry storage for 60 minutes. Then dental papilla was removed; root canal was prepared and filled with calcium hydroxide paste and root surface treatment was processed. Rats were randomly assigned into three groups: Control group: the incisor was replanted without any substance in the dental socket. SHEDs group: the tooth was replanted after infusion of SHED, re-suspended in platelet-rich-fibrin in the dental socket; platelet-rich-fibrin group: the incisor was replanted with platelet-rich-fibrin in the dental socket. Animals were euthanized on days 15, 30 and 60 after replantation; histological and histomorphometric analyses were performed. Results: Root resorption was present in all experimental groups. No statistically significant differences were observed in the final period of study. The control group showed more replacement resorption but SHEDs group, showed dental tissues were more preserved. Inflammatory resorption nearly did not affect any group, as expected in this protocol (p&lt;0.005). Conclusions: The findings of this study suggest that in the SHEDs group, teeth were more preserved with ankyloses occurrence, witch holds teeth in the socket for a longer period of time, when compared to replacement resorption or inflammatory resorption in the healing process of delayed replantation.

An experimental model for studies on delayed tooth replantation and ankylosis in rabbits.

To develop an experimental in vivo model to study dentoalveolar ankylosis and osseous replacement resorption after delayed replantation. The maxillary right incisors of eight rabbits were extracted and replanted, while the maxillary left incisors served as controls. A special technique for extraction was used, luxating the incisor laterally prior to extraction. Extra-oral root canal treatment was performed. In four of the eight replanted teeth, periodontal ligament was removed using gauze. All teeth were replanted after one-hour dry storage. A horizontal line was drilled on the labial enamel surface of the incisors to enable registration of possible subsequent infraposition. The rabbits were sacrificed after 1 week or 4 weeks, respectively. Percussion test of the teeth was carried out and infraposition was registered. Histological processing and evaluation were performed. Percussion sound was normal after 1 week and high in the 4 week group; infraposition was noted in all replanted teeth in the 4-week group. Fusion between the bone and dentin was seen in some areas on the root already after 1 week, but there was little or no osseous replacement. Larger areas of ankylosis were seen in the 4-week group although not significant, but deeper progressive osseous replacement was noted in this group. There was no significant difference in ankylosis with regard to periodontal ligament removal or not. Pulp and periodontal tissues were normal in all control teeth. The rabbit tooth model may be useful for experimental in-vivo studies on delayed replantation, subsequent ankylosis, osseous replacement and infraposition.

Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11) had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA) was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

Delayed tooth replantation after traumatic avulsion resulting in complete root resorption

Traumatic injuries of newly erupted permanent anterior teeth are common during childhood. Management of tooth avulsion in the permanent dentition often presents a challenge Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. This article describes the management of a 9-year-old child with an avulsed maxillary permanent incisor that had been air-dried for about 24 h. The replanted incisor retained its esthetic appearance and functionality only 1 year after replantation. In the present case, improper treatment measures such as prolonged dry conditions of the avulsed tooth before replantation, rigid splinting may explain rapid complete root resorption. Even if it is impossible to avoid resorption completely, the overall knowledge of both dentists and patients regarding immediate measures in case of traumatic dental injuries should be improved to delay the progress of resorption

The effect of propolis solution on root surface treatment in replanted teeth

Objective: The objective of this study was to assess the effect of propolis solution on root surface treatment in cases of delayed tooth replantation following chemical or mechanical removal of the periodontal ligament. Material and methods: Maxillary right central incisors of 36 male rats (Wistar) were extracted, kept in a dry environment for 15 minutes and then distributed into six groups, as follows: mechanical-propolis and mechanical-fluoride (mechanical removal followed by immersion in 6% propolis and 2% sodium fluoride, respectively), mechanical (mechanical removal only), chemical-propolis and chemical-fluoride (chemical removal followed byimmersion in 6% propolis and 2% sodium fluoride, respectively), and chemical (chemical removal only). Following periodontal ligament removal, root canals were filled with calcium hydroxide paste and replanted. After 60 days, histological analysis with light microscopy was carried out to detect areas of dentoalveolar ankylosis and root resorption. Results: Results revealed that chemical removal of the periodontal ligament was associated with slightly better tissue repair findings when compared with mechanical removal. Conclusions: The use of 6% propolis solution encouraged tissue repair, while the 2% sodium fluoride solution combined with chemical removal resulted in a better-organized healing process, with less destruction of dentine when compared with the 6% propolis solution.

Delayed tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline.

Systemic antibiotic therapy (SAT) has usually been recommended after tooth replantation, but its actual value has been questioned. As there are no reports in the literature about its influence on tooth replantation, the aim of this study was to evaluate the influence of systemic administration of antibiotics (amoxicillin and tetracycline) at the different phases of the repair process (7, 15, 30days) in delayed rat tooth replantation. Ninety Wistar rats (Rattus norvegicus albinus) had their maxillary right incisors extracted and bench-dried for 60min. The dental papilla, enamel organ, pulp tissue, and root surface-adhered periodontal ligament were removed, and the teeth were replanted. The animals received no antibiotics (n=30) or were medicated systemically with amoxicillin (n=30) and tetracycline (n=30), and were euthanized after 7, 15, and 30days. Regardless of the evaluation period, the acute inflammatory infiltrate was less intense and root resorption presented smaller extent and depth in the group treated with amoxicillin. The results suggest that SAT has a positive influence on the repair process in delayed tooth replantation and that amoxicillin is an excellent treatment option.

Could zoledronic acid prevent root resorption in replanted rat molar?

In this study, we evaluated whether zoledronate could suppress the progression of external root resorption in rat due to delayed replantation by inhibiting osteoclastic activity. Also, we estimated the optimal dosage of zoledronate in root treatment of the rat model for a maximum effect of zoledronate. Maxillary first molars in Sprague Dawley rats (N=84) were extracted, dried for 60min, and then replanted. The rats were divided into 6 groups (1mM alendronate, and 1, 5, 10, 20, 40μM zoledronate). At 4 and 8weeks postreplantation, the animals were sacrificed and evaluated by radiographic and histological analysis. There were no significant differences at 4weeks. However, at 8weeks, 10, 20, and 40μM ZOL showed more increased radiopaque and smaller periapical lesion in radiographic analysis. In histological analysis, all groups showed similar inflammatory root resorption rate at 4weeks. However, at 8weeks, 20 and 40μM ZOL showed lower rate than those of other groups (P<0.05). In concerning of replacement resorption, there were no significant differences statistically. In this animal experiment, zoledronate was capable of limiting the occurrence of root resorption in delayed replantation model. In particular, 20μM dosage of zoledronate solution showed the most effective dose in long-term follow up and might be suitable for inhibition of root resorption in delayed tooth replantation.

The effects of enzymatically synthesized glycogen on the pulpal healing process of extracted teeth following intentionally delayed replantation in mice

ObjectivesGlucose uptake plays a crucial role in early tooth morphogenesis and size determination. Recently, enzymatically synthesized glycogen (ESG), with the characteristics of natural glycogen (a major storage form of glucose), has been developed. This study aimed to elucidate the effectiveness of ESG on the pulpal healing process following intentionally delayed tooth replantation in mice. MethodsThe upper first molar was extracted, immersed in phosphate buffered saline (PBS) or ESG (5000kDa) solution (1mg/mL) for 60min, and then replanted. Immunohistochemistry (for nestin, osteopontin, and Ki-67), TUNEL assay, and reverse transcription-polymerase chain reaction were performed at different time points. ResultsIncreased apoptosis occurred in the dental pulp of mice from both treatment groups at Day 7, followed by active cell proliferation at Day 14 and tertiary dentin and/or bone-like tissue deposition at Day 21, in the PBS group. In contrast, active cell proliferation and coronal immunoreaction for nestin occurred around Day 10, and hard tissue deposition were observed at Day 14, in the ESG group. The mRNA expression of genes encoding dentin sialophosphoprotein and nestin first reappeared in the ESG group at Day 5, while expression levels of alkaline phosphatase and osteopontin, as well as Cd11c, tended to increase from Day 3 in both groups, and that of the stem cell marker, octamer-binding transcription factor Oct3/4, greatly enhanced at Day 1, particularly in the ESG group. ConclusionsESG improved the pulpal healing process of extracted teeth following intentionally delayed replantation, although both ESG and PBS may induce the formation of bone-like tissue.

Delayed tooth replantation following root canal filling with calcium hydroxide and MTA: Histomorphometric study in rats

ObjectiveThe aim of this study was to perform a histomorphometric evaluation of the repair process in rat teeth replanted after root canals were filled with calcium hydroxide (CH) and mineral trioxide aggregate (MTA). DesignUpper right incisors were extracted from 30 rats divided into three groups (n=10). The teeth were stored dry for 60min, after which the pulp and periodontal ligament (PDL) were removed and immersed in acidulated-phosphate sodium fluoride solution. In Group I, the root canals were filled with saline; in Group II, they were filled with CH; and in Group III, they were filled with CH, and the foramen was sealed with an MTA plug. The teeth were replanted, and the animals were sacrificed after 60 days. The sections with teeth were removed for histological preparation (haematoxylin and eosin, H&E). The characteristics of the PDL, cementum, dentine, and alveolar bone, as well as the occurrence of inflammatory and replacement root resorption and apical sealing, were subjected to histological and morphometric analysis (P<0.05). ResultsGroup I was the most affected by root resorption (mean=67.05%). In Groups II and III, the resorption averaged 42.2% and 11.7%, respectively. Group III was less affected by inflammatory resorption and presented more areas of apical sealing by mineralized tissue (P<0.05). ConclusionAn apical MTA plug improved the repair of the replanted tooth by decreasing surface resorption and repairing mineralized tissue in the periapical region.

Delayed tooth replantation: MTA as root canal filling.

MTA has been investigated as a root-end filling material. Its mechanism of action has some similarities to that of Ca(OH)2. The purpose of this study was to evaluate the repair process taking place in the delayed replantation of monkey teeth using calcium hydroxide and MTA as root canal filling materials. Five monkeys had their lateral incisors extracted and bench-dried for 60 minutes. After root canal preparation, the teeth were assigned to two groups according to root canal filling material: I, calcium hydroxide; and II, MTA. The same treatment sequence was followed for both groups: coronal seal, periodontal ligament removal, immersion of the tooth in 2% acidulated-phosphate sodium fluoride, irrigation of the socket with saline and replantation. Both groups exhibited replacement resorption, areas of ankylosis and absence of inflammatory root resorption. Statistically similar results (p > 0.05) were observed for both groups regarding replacement root resorption, but the groups differed significantly (p < 0.05) regarding the occurrence of ankylosis. MTA may be a viable clinical option for filling teeth submitted to delayed replantation, and is an acceptable option for treating replanted permanent teeth in order to prevent tooth resorption, particularly when dressing changes are not possible.