The aim of the present investigation was to study the frequency of pulp revascularization in therapeutically reimplanted incisors as well; is its relationship with the following factors: width of apical foramen, duration of extra‐alveolar lime, storage conditions and postoperative administration of antibiotics. Out of 72 immature teeth (width of apical foramen 1.1–5.0 mm) the pulp was revascularized in 13 (18%), while in 88 mature teeth (width of apical foramen 1.0 mm or less) no revascularization occurred. Among parameters tested statistically in immature teeth, a significantly increased frequency of revascularization (p < 0.05) was only found in teeth reimplanted within 45 minutes after avulsion, when compared with teeth reimplanted after a longer extra‐alveolar time, and in mandibular incisors when compared with maxillary incisors (p < 0.01). All teeth in which revascularization did not occur exhibited a periapical radiolucency and/or external inflammatory root resorption.
Maxillary incisors in 47 monkeys, 54 in the experimental group (I) and 117 in the control group (II), were extracted and reimplanted, either immediately or after 30 or 60 min wet or dry storage. Incisors in the experimental group I were additionally kept 5 min in a suspension of 1 mg doxycycline in 20 ml physiologic saline, freshly prepared for each of the 15 animals before reimplantation. The observation time varied from 6 to 8 weeks. The teeth were removed in tissue blocks, histologically processed and evaluated for occurrence of complete pulp revascularization (CPR), presence of the micro-organisms in the pulpal lumen and ankylosis or inflammatory root resorption. Then the results were statistically evaluated, using log-linear analyses and chi-square tests (SAS, 1985) for the comparisons between group I and group II. These analyses revealed that topical application of doxycycline increased the frequency of complete pulp revascularization (P less than 0.002) and decreased the frequency of micro-organisms in the pulpal lumen (P less than 0.001). Furthermore, the frequencies of ankylosis (P less than 0.05) and inflammatory root resorption (P less than 0.001) were also decreased compared with the control group of teeth. It was concluded that the effect of topical treatment with doxycycline was most probably exerted on the micro-organisms that contaminated root surface during the extra-alveolar time; contamination of necrotic pulp tissue from the mechanical damage in the cervical part of the root surface was not affected.
In 32 monkeys 105 immature maxillary incisors were extracted and reimplanted either immediately or after 30 or 60 min wet or dry storage. Of the monkeys, 17 (group I) did not receive and 15 (group II) received prophylactic treatment with 4 mg/kg doxycycline before extraction and 2 mg/kg for 5 d after reimplantation. The observation time varied from 6 to 8 weeks. After being histologically processed, the material was evaluated with respect to the amount of vital tissue and presence of micro-organisms in the pulpal lumen. A comparison revealed no difference in the results between the groups. The results were therefore pooled and statistically analysed with respect to the significance of apical foramen width, extra-alveolar time, wet or dry storage and presence of micro-organisms in the pulpal lumen for the occurrence of complete pulp revascularization (CPR). The overall frequency of CPR was 18%. Log-linear analyses (SAS, 1985) of the material as a whole or of separate parameters consistently revealed a relationship between presence of micro-organisms and absence of CPR (P = 0.0001). A higher frequency of CPR and a lower frequency of micro-organisms (P = 0.05) was found only for the group of immediately reimplanted teeth. The presence of micro-organisms could be explained for 61 teeth. In 27 of these, blood clots containing bacteria in the apical portion of pulpal lumen indicated contamination during the extra-alveolar time, while in 34, the micro-organisms originated from plaque covered mechanical damage in the cervical part of the root surface.
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