Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany.
Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany.
J Endod. 2019 Nov;45(11):1390-1396. doi: 10.1016/j.joen.2019.07.012. Epub 2019 Aug 30.
External cervical resorption (ECR) often renders a tooth nonrestorable, especially if it extends deeply within the dental hard tissue. Intentional replantation is sometimes performed as the last resort to save the tooth but may limit conventional forceps extraction because of the high risk of periodontal ligament cell damage or crown fracture.This case report describes the intentional replantation of an upper central incisor with extensive ECR using an axial, atraumatic extraction system to save the otherwise hopeless tooth. The patient was an asymptomatic 37-year-old man with no contributing medical history. The treatment protocol included atraumatic extraction followed by granulation tissue removal, extraoral root canal treatment, and adhesive restoration of the extensive resorption defect. During extraoral manipulation, the utmost care was taken to prevent root surface drying, contamination with dental adhesive, or heat-induced periodontal ligament damage during curing. Two and a half years after replantation, clinical and radiographic examinations revealed normal healing and no symptoms but a slight reduction of bone level compared with the preoperative level and no signs of root resorption or ankylosis. The successful outcome in this case supports the idea of performing intentional replantation with an atraumatic extraction system to save teeth with extensive cervical root resorption and a high risk of fracture during extraction.
外部性颈吸收（ECR）常使牙齿无法修复，尤其是当它在牙本质深处延伸时。为了保存牙齿，有时会进行有意再植，作为最后的手段，但由于牙周膜细胞损伤或冠折的高风险，可能会限制传统的钳子拔牙。本病例报告描述了使用轴向、无创伤拔牙系统对一例广泛 ECR 的上颌中切牙进行有意再植，以保存这颗原本无望的牙齿。患者为无症状的 37 岁男性，无相关病史。治疗方案包括无创伤拔牙，然后切除肉芽组织，进行外根管治疗，以及对广泛吸收缺陷进行粘结修复。在进行外操作时，要格外小心，防止根面干燥、与牙胶粘连、或在固化过程中热诱导牙周膜损伤。再植后 2 年半，临床和影像学检查显示正常愈合，无任何症状，但与术前水平相比，骨水平略有下降，无根吸收或粘连迹象。本病例的成功结果支持使用无创伤拔牙系统进行有意再植的观点，以保存有广泛颈根吸收和在拔牙过程中骨折风险高的牙齿。
