The present clinical study investigated the outcome of intentional
replantation using resection of the ankylosed sites of the root, extraoral endodontic treatment using
titanium posts and
Emdogain for periodontal healing following
trauma-related
ankylosis. During an evaluation period of 6 years, 16 ankylosed teeth affected by replacement resorption were treated as described. Evaluation parameters before treatment and during the follow-up period included Periotest scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. In a second accident, one tooth was lost after 7 months and was excluded as a dropout.
Ankylosis did not recur in seven replanted teeth, which were observed for an average of 52.3 months (range: 24-68 months).
Ankylosis recurred in eight teeth after an average period of 12 months (range: 4-26 months). An infraocclusion, normal or only slightly reduced Periotest scores and normal percussion sound were preoperatively found in six of seven successfully replanted teeth, which corresponded to a relatively small area of
ankylosis. The majority of the teeth showing recurrent
ankylosis preoperatively presented with normal position, negative Periotest scores and a high percussion sound which corresponded to an extended area of
ankylosis. Statistically significant relationship between preoperative findings and the treatment outcome (P = 0.031) have become apparent. The results indicate that the treatment of minor areas of
ankylosis by intentional
replantation, resection of the ankylosed sites and
Emdogain appeared to prevent or delay the recurrence of
ankylosis in 7 of 15 teeth.