Retrospective Analysis of Clinical Characteristics and Therapeutic Effect of Intentional Replantation.

INTRODUCTION

A retrospective analysis of a large group of cases was conducted to examine the clinical traits of teeth subjected to intentional replantation (IR) and the factors influencing the treatment effect, so as to provide guidance for indication selection and surgical operations.

METHODS

A total of 445 patients, each with one affected tooth, underwent IR surgery at West China Hospital of Stomatology, Sichuan University, from 2016 to 2023, were included. Data on basic patient information, preoperative status, intraoperative procedures, and follow-up results for 107 patients with a follow-up duration exceeding 1 year were collected. Statistical analysis was performed using SPSS.

RESULTS

The results showed that most IR patients were female (62.25%) and aged between 21 and 50 (80.45%). The predominant teeth for surgery were the mandibular second molars (44. 94%), maxillary second molars (19.33%), and maxillary lateral incisors (11.24%). The main preoperative symptoms were percussion pain (78. 65%), periodontal pockets (50.11%), sinus tract (40.45%), and tooth mobility (30.79%). The rate of completing preoperative root canal treatment was 93.71%. During surgery, 66 teeth (14.83%) had root surface cracks. Sixty-two of these teeth were not reimplanted during the operation; 47 of 62 (75.81%) had vertical root fractures. The overall success rates were 78.50%. Univariate analysis showed that the lack of periodontal pockets and the absence of bony plate defects significantly increased the success rate (P < .05). The success rate for severe coronal defects and root defects on the distal surface of the second molar was 73.68%.

CONCLUSION

IR can be used for complex endodontic and periapical diseases, as well as teeth with periodontitis, serving as a viable solution for salvaging challenging teeth. The periodontal status, initial etiology, and the severity of the bony plate defect are key prognostic factors.