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DT Israel

12Dentaltribune israel edition Endo Tribune 46 months of follow-up. Majorana et al.20 followed 45 cases of dental trauma for five years, recording complications and responses to treatment. Root resorption was observed in 45 cases (17.24%). Of these, nine were associated with luxation injury (20%) and 36 (80%) with avulsion. The authors identified 30 cases of inflammatory root resorption (18 transient and 12 progressive) and 15 cases of ankylosis and osseous replacement. Aqrabawi18 evaluated two cases of IR and retrograde filling of mandibular second molars. At the fiveyear recall visit, radiographs showednoevidenceofpathological changes. Nuzzolese et al.21 state that the success rate of IR at five years reported in the literature ranges from 70 to 91%. Al-Hezaimi et al.22 treated a radicular groove that predisposed a 15-year-old girl to a severe periodontal defect with a combination of endodontic, IR and Emdogain (Straumann) therapy. At the one-year follow-up, the patient was comfortable and active healing was evident. Demiralp et al.23 evaluated the clinical and radiographic results of IR of periodontally involved teeth after conditioning root surfaces with tetracycline hydrochloride. Thirteen patients (seven women and six men; age range: 35–52 years) with 15 periodontally involved non-salvageable teeth were included in this study. During the replantation procedure, the affected teeth were gently extracted and the granulation tissue, calculus, remaining PDL and necrotic cementum on the root surfaces were removed. Tetracycline hydrochloride, at a concentration of 100mg/ml, was applied to the root surfaces for 5 minutes. The teeth were then replaced in their sockets and splinted. After six months, no root resorption or ankylosis was observed radiographically. Although the period of evaluation was short, the authors suggest that IR maybe an alternative approach to extraction in cases in which advanced periodontal destruction is present and no other treatment can be considered. Araujo et al.24 demonstrated that root resorption, ankylosis and new attachment formation, among other processes, characterised healing of a replanted root that had been extracted and deprived of vital cementoblasts. It was also demonstrated that Emdogain therapy, that is, conditioning with EDTA and placement of enamel matrix proteins on the detached root surface, did not interfere with the healing process. Peer25 reviewed nine cases of IR that illustrated the feasibility of the procedure for a variety of indications. Only one case of replantation showed evidence of pathosis, reflected by root resorption or ankylosis. His report suggests that IR is a reliable and predictable procedure, and should be considered more often as a treatment method to maintain the natural dentition. Yuetal.26 reportedacaseinwhicha combined endodontic-periodontic lesion on a mandibular first molar was treated by IR and application of hydroxyapatite. Four months after the surgery, a porcelain–metal fullcrown restoration was completed. At the 15-month follow-up examination, the tooth was clinically and radiographically healthy and functioned well. Shintani et al.27 performed an IR of an immature mandibular incisor that had a refractory periapical lesion. The incisor was extracted and the periapical lesion was removed by curettage. The root canal of the tooth was then rapidly irrigated, and filled with a calcium hydroxide and iodoform paste, after which the tooth was secured with an archwire splint. Five years later, no clinical or radiographic abnormalities were found, and the root apex was obturated by an apical bridge formation. Kaufman28 reported successful results of a maxillary molar tooth treated with IR after a four-year follow-up period. A mandibular first molar, which was replanted, by Czonstkowsky and Wallace29 showed no signs of resorption and ankylosis after six months.14 Different investigators reported success rates varying from 52 to 95% with follow-ups of between one to 22 years in posterior teeth.2,15–17 Bender and Rossmann19 reported a success rate of 77.8% in molars. Among 14 mandibular molars, the success rate in first molars was 85.7%, and 71.4% in second molars. Of the four maxillary molars, three first molars and one second molar, one maxillary first molar failed, resulting in a 66.7% success rate in first molars.2 Raghoebar and Vissink30 replanted 29 teeth, consisting of two mandibular first molars, 17 mandibular second molars, one mandibular third molar and nine maxillary second molars, and followed them for an average of 62 months. The success rate was 72% and 25 of them were still in function.18 Conclusion For extraction and replantation to be successful, the following criteria must be met: • Informed consent must be obtained from the patient. • All roots need to be conically shaped. • The teeth need to be somewhat mobile. • A good knowledge of oral surgery is needed with respect to extraction. Intentional replantation is a treatment alternative that should not be underrated, especially when conventional endodontic or surgical treatment is not possible. This is an excellent treatment with a predictable result. I have performed approximately 30 replantations, and have lost only one tooth to date. In order to be successful with extraction and replantation cases, the practitioner must have the right patient and the right rapport with that patient. The practitioner must also be able to assess the tooth and be confident that it can be extracted without breakage. Additionally, the practitioner must be able to recognize tooth morphologies that may lead to extraction problems. This is a skill that is perfected through experience. Replantation is a predictable and acceptable method of treatment in my office when patients present with root canals that require retreatment due to failure or those that cannot be completed owing to sclerosing of the canals._ Editorialnote:Acompletelistofreferences is available from the publisher Dr Muhamad Abu-Hussein 123 Argus St. 10441 Athens Greece abuhusseinmuhamad@gmail.com Contact Info Fig. 9_A follow-up radiograph after one year. Fig. 10_A follow-up radiograph after three years. Fig. 11_A follow-up radiograph after four years. Fig. 12_A follow-up radiograph after eight years. DTI EVENT PLANNER 2014 DATE EXHIBITION/CITY 1 Quarter 2014 N/A Saudi Dental Society Meeting/Riyadh Jan 30-Feb 2, 2014 Yankee Dental Meeting/Boston Jan 30-Feb 2, 2014 CIOSP/Sao Paulo Feb 4-6, 2014 AEEDC/Dubai Feb 7-8, 2014 SIO Congress/Milan Feb 20-22, 2014 Chicago Midwinter Meeting/Chicago Mar 6-8, 2014 Krakdent/Cracow Mar 6-8, 2014 Pacific Dental Conference/Vancouver Mar 6-9, 2014 Dental South China/Guangzhou Mar 13-15, 2014 Expodental/Madrid Mar 20-22, 2014 Dental Expo/Amsterdam Mar 21-23, 2014 ADX14/Sydney Mar 27-29, 2014 Hinman Dental Meeting/Atlanta 2 Quarter Apr 2-4, 2014 Scandefa/Copenhagen Apr 4-6, 2014 IDEM/Singapore Apr 21-24, 2014 Dental Salon/Moscow Apr 25-29, 2014 AAO Annual Session/New Orleas Apr 30-May 3, 2014 AACD/Orlando DATE EXHIBITION/CITY May 9-11, 2014 SIDEX/Seoul N/A AMIC Spring/Mexico City May 15-17, 2014 CDA/Anaheim May 16-17, 2014 WID/Vienna May 20-22, 2014 Buldental/Sofia May 22-24, 2014 Amici di Brugg/Rimini May 22-24, 2014 Dental Bern/Bern May 23-27, 2014 JDIQ/Montreal Jun 9-12, 2014 Sino-Dental/Beijing Jun 17-19, 2014 APDC/Dubai 3 Quarter 2014 N/A HKIDEAS/Hong Kong Sep 4-6, 2014 CDA/San Francisco N/A China Dental Show/Shanghai Sep 11-13, 2014 CEDE/Poznan Sep 11-14, 2014 FDI Word Dental Congress/New Delhi Sep 18-20, 2014 Dentex/Brussels Sep 25-27, 2014 Slovak Dental Days/Bratislava Sep 26-27, 2014 Fachdental/Leipzig N/A Dental-Expo/Moscow DATE EXHIBITION/CITY 4 Quarter 2014 Oct 3-5, 2014 ICOI Word Dental Congress/Tokyo N/A World Dental Show/Mumbai Oct 9-11, 2014 Pragodent/Prague Oct 9-11, 2014 DentalWorld/Budapest Oct 9-11, 2014 MediDent/Belgrade Oct 9-14, 2014 ADA/San Antonio Oct 10-11, 2014 Fachdental/Stuttgart N/A EAO N/A BDTA Dental Showcase/London Oct 16-18, 2014 Expodental/Milan Oct 22-25, 2014 Den Tech/Shanghai Nov 7-8, 2014 German Dental Day/Frankfurt N/A Dental Istanbul/Istanbul N/A AMIC Fall/Mexico City N/A Swedental/Goteborg N/A Expo-Dentaria/Porto Nov 19-22, 2014 DENTA/Buncharest Nov 25-29, 2014 ADF/Paris Nov 28-Dec 3, 2014 GNYDM/New York