J Dent Rehabil Appl Sci.  2019 Jun;35(2):98-104. 10.14368/jdras.2019.35.2.98.

Treatment of a tooth with severe periodontal involvement using intentional replantation: case report

• Choi YK
• Jung KH
• Lee JY
• Joo JY
• Kim HJ
• Kwon EY

• KMID: 2451757
• DOI: http://doi.org/10.14368/jdras.2019.35.2.98

Abstract

Although intentional replantation is frequently used as a treatment modality for endodontic problems, severe periodontal involvement has usually been regarded as a contraindication. However, there are some studies suggesting that intentional replantation could be a successful treatment alternative for periodontally involved teeth. This paper reports the treatment of a tooth with severe periodontal involvement using intentional replantation. The tooth, which had had root canal therapy due to endodontic-periodontal combined lesion but showed extensive bone loss, was gently extracted and replanted after thorough debridement of the root surface. By intentional replantation, a tooth with severe periodontal involvement in this case could be preserved, without extraction, over the course of a 3-year follow-up period.

Keyword

alveolar bone loss; periodontal attachment loss; periodontal diseases; root canal therapy; tooth replantation

MeSH Terms

Alveolar Bone Loss
Debridement
Follow-Up Studies
Periodontal Attachment Loss
Periodontal Diseases
Replantation*
Root Canal Therapy
Tooth Replantation
Tooth*

Figure

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  Fig. 1 Clinical view of case. (A) Gingival swelling and redness of the mandibular right canine were detected at first visit, (B) Pus discharge from gingival sulcus was found at 6 month after root canal therapy, (C) Calculus and inflamed tissue were observed during intentional replantation, (D) Replanted tooth was splinted with adjacent teeth and occlusal adjustment was performed.

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  Fig. 2 Intraoral periapical radiograph of case. (A) Marginal bone loss extended to apical area in the mandibular right canine was observed at initial visit, (B) During root canal therapy, (C) Immediately after root canal filling, (D) Severe alveolar bone loss extended to adjacent tooth was found at 6 month after root canal therapy.

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  Fig. 3 Clinical view of case during followup period. (A) Gingival swelling and pus discharge disappeared at 6 month after intentional replantation, (B) Decreased mobility was confirmed and material used for splinting was removed partially at 1 year after intentional replantation, (C) Two year after intentional replantation, (D) Three year after intentional replantation.

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  Fig. 4 Intraoral periapical radiograph of case during follow-up period. (A) Alveolar bone regeneration around replanted tooth was found at 6 month after intentional replantation, (B) One year after intentional replantation, (C) Two year after intentional replantation, (D) Three year after intentional replantation.

Reference

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