The aim of this article is to summarize the biologic principles required for successful autotransplantation of teeth. Indications, armamentarium, technique and prognosis will be discussed.

Autotransplantation of teeth: requirements for predictable success.

Viable Bacteria in Root Dentinal Tubules of Teeth with Apical Periodontitis

The aim of the present investigation was to study the frequency of pulp revascularization in therapeutically reimplanted incisors as well; is its relationship with the following factors: width of apical foramen, duration of extra-alveolar lime, storage conditions and postoperative administration of antibiotics. Out of 72 immature teeth (width of apical foramen 1.1–5.0 mm) the pulp was revascularized in 13 (18%), while in 88 mature teeth (width of apical foramen 1.0 mm or less) no revascularization occurred. Among parameters tested statistically in immature teeth, a significantly increased frequency of revascularization (p < 0.05) was only found in teeth reimplanted within 45 minutes after avulsion, when compared with teeth reimplanted after a longer extra-alveolar time, and in mandibular incisors when compared with maxillary incisors (p < 0.01). All teeth in which revascularization did not occur exhibited a periapical radiolucency and/or external inflammatory root resorption.

Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors

Dental trauma represents one of the few situations where dentists are called upon to make unscheduled diagnostic and treatment decisions in an area that is outside their routine experience. Since patients who sustain an avulsion present infrequently, except in child-oriented or emergency-based practices, clinicians often make diagnostic and management decisions based upon their previous rare treatment experiences. Clinicians also rely on published guidelines for this aspect of their practice and expect these standards to be up-to-date and based on current research information. None of the current protocols has been tested by a prospective longitudinal outcome study in humans. Nevertheless, current guidelines have become the standard for clinical practice around the world. An effort must be made to develop treatment protocols that are based upon the biological mechanisms that underlie periodontal wound healing.

Avulsed permanent teeth: a review of the literature and treatment guidelines

Maxillary incisors in 47 monkeys, 54 in the experimental group (I) and 117 in the control group (II), were extracted and reimplanted, either immediately or after 30 or 60 min wet or dry storage. Incisors in the experimental group I were additionally kept 5 min in a suspension of 1 mg doxycycline in 20 ml physiologic saline, freshly prepared for each of the 15 animals before reimplantation. The observation time varied from 6 to 8 weeks. The teeth were removed in tissue blocks, histologically processed and evaluated for occurrence of complete pulp revascularization (CPR), presence of the micro-organisms in the pulpal lumen and ankylosis or inflammatory root resorption. Then the results were statistically evaluated, using log-linear analyses and chi-square tests (SAS, 1985) for the comparisons between group I and group II. These analyses revealed that topical application of doxycycline increased the frequency of complete pulp revascularization (P less than 0.002) and decreased the frequency of micro-organisms in the pulpal lumen (P less than 0.001). Furthermore, the frequencies of ankylosis (P less than 0.05) and inflammatory root resorption (P less than 0.001) were also decreased compared with the control group of teeth. It was concluded that the effect of topical treatment with doxycycline was most probably exerted on the micro-organisms that contaminated root surface during the extra-alveolar time; contamination of necrotic pulp tissue from the mechanical damage in the cervical part of the root surface was not affected.

Effect of topical application of doxycycline on pulp revascularization and periodontal healing in reimplanted monkey incisors.

Relationship between surface and inflammatory resorption and changes in the pulp after replantation of permanent incisors in monkeys.

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Relationship between surface and inflammatory resorption and changes in the pulp after replantation of permanent incisors in monkeys.