Cho Sin-Yeon, Lee Seung-Jong, Kim Euiseong
Department of Dentistry and Institute for Translational and Clinical Research, International St Mary's Hospital, Catholic Kwandong University, Incheon, Korea.
Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
J Endod. 2017 Apr;43(4):550-555. doi: 10.1016/j.joen.2016.11.024. Epub 2017 Feb 16.
Periodontal involvement has been thought to be a contraindication for intentional replantation. This retrospective study aimed to assess clinical outcomes after intentional replantation of teeth with periodontal involvement and to explore potential predictors of outcomes.
Teeth with a history of intentional replantation between March 2000 and December 2014 and with 1 or 2 preoperative periodontal pockets ≥6 mm among 6 sites evaluated per tooth were included. A total of 103 teeth were included, and 74 teeth were followed up for more than 6 months. Outcomes were assessed as improved (a decrease in the number and depths of periodontal pockets and the size of periapical radiolucency and no external root resorption or sign/symptoms) or failed. Data were analyzed with Kaplan-Meier survival analysis and a Cox proportional regression model.
Cumulative improved rates declined from 89% at 1 year to 68% at 4 years. A Cox proportional regression model identified the patient's age (P = .049; hazard ratio, 2.552) and the number of preoperative periodontal pockets with a depth ≥6 mm (P = .041; hazard ratio, 2.523) as predictors of outcomes in the replantation of periodontally involved teeth.
Periodontal involvement is not an absolute contraindication to intentional replantation. The teeth with 1 preoperative periodontal pocket ≥6 mm and the subjects aged ≤40 years had 2.5 times and 2.6 times lower probability of failure, respectively, than the teeth with 2 pockets and the subjects aged >40 years. Therefore, these factors need to be carefully considered for intentional replantation.
牙周病变一直被认为是牙齿有意再植的禁忌证。本回顾性研究旨在评估牙周受累牙齿有意再植后的临床结果,并探索结果的潜在预测因素。
纳入2000年3月至2014年12月间有有意再植史且每颗牙齿评估的6个部位中有1个或2个术前牙周袋≥6mm的牙齿。共纳入103颗牙齿,其中74颗随访超过6个月。结果评估为改善(牙周袋数量和深度、根尖周透射影大小减少,且无牙根外吸收或体征/症状)或失败。采用Kaplan-Meier生存分析和Cox比例回归模型进行数据分析。
累积改善率从1年时的89%降至4年时的68%。Cox比例回归模型确定患者年龄(P = .049;风险比,2.552)和术前深度≥6mm的牙周袋数量(P = .041;风险比,2.523)为牙周受累牙齿再植结果的预测因素。
牙周受累并非牙齿有意再植的绝对禁忌证。术前有1个牙周袋≥6mm的牙齿和年龄≤40岁的受试者失败概率分别比有2个牙周袋的牙齿和年龄>40岁的受试者低2.5倍和2.6倍。因此,对于有意再植,需要仔细考虑这些因素。