Division of Endodontics and Periodontics, Department of Stomatology, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Endodontics and Periodontics, Department of Stomatology, Taichung Veterans General Hospital, Taichung, Taiwan; College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; School of Dentistry, National Yang Ming University, Taipei, Taiwan.
J Formos Med Assoc. 2021 Jan;120(1 Pt 2):346-353. doi: 10.1016/j.jfma.2020.05.017. Epub 2020 Jun 1.
BACKGROUND/PURPOSE: Intentional 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.
Subjects 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.
Kaplan-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.
Intentional 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.
背景/目的：在牙髓学的手术治疗中，再植术是一种常规的治疗方法，但通常被视为最后的手段。因此，本研究的目的是评估在台湾人群中，再植术的长期治疗效果，包括存活率和相关的预后因素。
本研究纳入了一家台湾医学中心的 199 名患者的 215 颗接受了再植术的牙齿。排除年龄小于 20 岁和随访时间少于 6 个月的患者。将再植牙随访 6 个月至 120 个月。通过临床和影像学检查，对治疗后的牙齿存活和功能状态进行评估。
Kaplan-Meier 生存分析显示，4 年时的总体牙齿存活率为 82.8%。在单因素分析中，根管充填材料和釉基质衍生物（EMD）的应用均有显著意义（P<0.05）。多因素分析显示，年龄和窦道或脓肿的存在可能是再植术治疗结果的预测因素。
采用改良的现代技术进行的再植术是一种可靠且可行的治疗方法，具有较高的长期存活率（82.8%）。如果在术前检查中诊断为急性或慢性根尖脓肿，其失败风险比其他情况高 2.7 倍。将 EMD 应用于再植牙的根面可能会促进牙周组织的形成和再生，从而提高功能率并改善治疗效果。
