Study on Treatment Results and Bone Changes After Replanting Severely Affected Teeth - A Before-and-After Study.
Assessment of Treatment Outcomes and Alveolar Bone Changes Following Intentional Replantation of Hopeless Periodontally Involved Single-Rooted Teeth - A Pre-test, Post-test Interventional Study
University of Fujairah
45 participants
Mar 25, 2024
INTERVENTIONAL
Conditions
Summary
This research aims to evaluate the effectiveness of intentional replantation (IR) as a treatment for single-rooted teeth diagnosed as hopeless due to true periodontic lesions. The study will assess changes in alveolar bone and periodontal tissues, symptom resolution, and patient-reported outcomes (satisfaction and quality of life) following the procedure. Cone beam computed tomography (CBCT) imaging will be used to track radiographic changes at baseline and 9 months, while clinical examinations will monitor symptom resolution, including pain, swelling, and tooth mobility. The study is a single-arm pre-test, post-test interventional design conducted at the College of Dentistry, University of Science and Technology Fujairah (new name: University of Fujairah). Participants will include adults aged 18-70 with single-rooted teeth deemed hopeless due to periodontic lesions. Participants will undergo intentional replantation, and data will be collected through clinical examinations, radiographic images, and patient questionnaires at baseline and 9 months. Statistical analysis will compare pre- and post-treatment outcomes using paired-samples t-tests or Wilcoxon signed-rank tests, depending on data normality. The study aims to provide a comprehensive evaluation of intentional replantation, contributing valuable insights into its clinical effectiveness for managing complex dental conditions.
Eligibility
Inclusion Criteria8
- Patients meeting the specified criteria will be included in the study.
- The patients with American Society of Anesthesiologists physical status classification 1 and 2.
- Radiographic bone loss of at least 50% around the targeted tooth.
- Probing depth of at least 5 millimetres around the targeted tooth.
- Grade III mobility (extreme mobility) of the targeted tooth according to Miller's classification.
- Grade II mobility or less (minimal to slight increased mobility without functional impairment) of adjacent teeth.
- Distance between the targeted tooth and adjacent teeth less than 2 millimetres.
- Patient preference for tooth retention through intentional replantation over extraction.
Exclusion Criteria3
- Previous history of failed IR.
- Severe anatomical limitations in the treatment area.
- Unwillingness to adhere to follow-up protocols
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Interventions
The intervention involves intentional replantation (IR) of periodontally compromised single-rooted teeth. Patients are selected based on criteria ensuring no vertical root fractures and potential for restoration. Preoperative preparation includes radiographic evaluation (CBCT/periapical), scaling, and root planing, along with antibiotic prophylaxis. The tooth is extracted non-traumatically using periotomes to preserve the periodontal ligament (PDL). After extraction, the tooth is stored in a sterile medium and granulation tissue is excised. Optional modifications (apical resection, retrograde filling, or surface treatment) may be performed. The tooth is then replanted into the socket, secured with a non-rigid splint, and occlusal adjustment is made. Postoperative care includes analgesics, antibiotics, and chlorhexidine rinse. Follow-ups are scheduled at 1 week, 4 weeks, and 9 months for evaluation of healing, survival, and patient-reported outcomes.
Locations(1)
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NCT06893107