• Shao-Ying Wu and Gin Chen.
• Division of Endodontics and Periodontics, Department of Stomatology, Taichung Veterans General Hospital, Taichung, Taiwan.
• J Formos Med Assoc. 2021 Jan 1; 120 (1 Pt 2): 346-353.

Background/PurposeIntentional replantation was a conventional treatment option in surgical endodontics but usually be seen as a last resort. Therefore, the purpose of this study was to evaluate the long-term treatment outcome of intentional replantation in Taiwanese population, including the survival rates and the related prognostic factors.MethodsSubjects included 215 teeth from 199 patients who had received intentional replantation in a Taiwan medical center. Patients at age under 20 years and those follow-up periods less than 6 months were excluded. The replanted teeth were followed up for a period of 6 months-120 months. Post-treatment assessments, including tooth survival and functional status, were evaluated using both clinical and radiographic examinations.ResultsKaplan-Meier survival analysis revealed the overall tooth survival rate at 4 years was 82.8%. In bivariate analysis, both root-end filling material and enamel matrix derivative (EMD) applications were found to be significant (P < 0.05). The multivariate analysis revealed that age and the presence of a sinus tract or abscess might be the predictors of treatment outcome in intentional replantation.ConclusionIntentional replantation, operated with improved modern technique, is a reliable and viable treatment with a high long-term survival rate (82.8%). If replanted teeth are diagnosed as acute or chronic apical abscess at the pre-operative examination, the risk of failure is measured 2.7 times higher than those diagnosed with other conditions. Application of EMD on the root surface of a replanted tooth may promote the formation and regeneration of periodontal apparatus, therefore increasing the functioning rate and improving the treatment outcome.Copyright © 2020. Published by Elsevier B.V.

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