Abstract:Traditionally, when a root-originated fracture (ROF) was diagnosed in an endodontically treated tooth, the tooth was scheduled for extraction. However, modern endodontics offers new treatment options to manage and maintain certain ROF teeth. The decision of whether to extract a ROF tooth and substitute it with a dental implant, or to implement a more conservative management approach by attempting an additional endodontic treatment aimed to preserve the natural tooth, is complicated and multifactorial. The mana… Show more
“…The high positive interaction between resection and preparation suggests that a high resection is indicated for a high preparation . This result can be explained by the fact that a high preparation level induces very thin dentin walls prone to fracture, but this would have been attenuated by a higher level of resection [ 25 ]. Considering all coefficients of the equation, the DOE suggested that nearly half of the biomechanical impact is missed without considering interactions between factors, which is of great importance because these interactions should be present in all situations encountered in EMS.…”
Background: The present study aimed to classify the relative contributions of four biomechanical factors—the root-end filling material, the apical preparation, the root resection length, and the bone height—on the root stresses of the resected premolar. Methods: A design of experiments approach based on a defined subset of factor combinations was conducted to calculate the influence of each factor and their interactions. Sixteen finite element models were created and analyzed using the von Mises stress criterion. The robustness of the design of experiments was evaluated with nine supplementary models. Results: The current study showed that the factors preparation and bone height had a high influence on root stresses. However, it also revealed that nearly half of the biomechanical impact was missed without considering interactions between factors, particularly between resection and preparation. Conclusions: Design of experiments appears to be a valuable strategy to classify the contributions of biomechanical factors related to endodontics. Imagining all possible interactions and their clinical impact is difficult and can require relying on one’s own experience. This study proposed a statistical method to quantify the mechanical risk when planning apicoectomy. A perspective could be to integrate the equation defined herein in future software to support decision-making.
“…The high positive interaction between resection and preparation suggests that a high resection is indicated for a high preparation . This result can be explained by the fact that a high preparation level induces very thin dentin walls prone to fracture, but this would have been attenuated by a higher level of resection [ 25 ]. Considering all coefficients of the equation, the DOE suggested that nearly half of the biomechanical impact is missed without considering interactions between factors, which is of great importance because these interactions should be present in all situations encountered in EMS.…”
Background: The present study aimed to classify the relative contributions of four biomechanical factors—the root-end filling material, the apical preparation, the root resection length, and the bone height—on the root stresses of the resected premolar. Methods: A design of experiments approach based on a defined subset of factor combinations was conducted to calculate the influence of each factor and their interactions. Sixteen finite element models were created and analyzed using the von Mises stress criterion. The robustness of the design of experiments was evaluated with nine supplementary models. Results: The current study showed that the factors preparation and bone height had a high influence on root stresses. However, it also revealed that nearly half of the biomechanical impact was missed without considering interactions between factors, particularly between resection and preparation. Conclusions: Design of experiments appears to be a valuable strategy to classify the contributions of biomechanical factors related to endodontics. Imagining all possible interactions and their clinical impact is difficult and can require relying on one’s own experience. This study proposed a statistical method to quantify the mechanical risk when planning apicoectomy. A perspective could be to integrate the equation defined herein in future software to support decision-making.
“…Intentional replantation has also been used as a method that allows extra-oral bonding of teeth with vertical root fractures (Hayashi et al, 2002(Hayashi et al, , 2004Nizam et al, 2016;Okaguchi et al, 2018;Rosen et al, 2018;Sugaya et al, 2016). It has also been used as a treatment option to treat teeth considered as having a periodontally poot prognosis (Hou et al, 2016;Saida et al, 2018;Solakoglu & Filippi, 2017).…”
Surgical extrusion, intentional replantation and tooth autotransplantation procedures are important treatment options that clinicians may consider performing in their day-to-day clinical practice. Despite compromised teeth are generally considered for extraction, clinicians must be aware that these cases could be suitable for management by these alternative predictable treatment options. Surgical extrusion, intentional replantation or tooth autotransplantation have similar treatment protocols which includes atraumatic tooth extraction, visualisation of the root portion and replantation. Surgical extrusion is defined as the 'procedure in which the remaining tooth structure is repositioned at a more coronal/supragingival position in the same socket in which the tooth was located originally'. Intentional replantation is defined as the 'deliberate extraction of a tooth and after evaluation of root surfaces, endodontic manipulation and repair, placement of the tooth back into its original position'. Tooth autotransplantation is defined as the 'transplantation of an unerupted or erupted tooth in the same individual, from one site to another extraction site or a new surgically prepared socket'. The same team previously published a narrative review (
“…Teeth with vertical root fractures are usually deemed nontreatable. However, in the rare cases in which maintaining a tooth with vertical root fracture seems crucial due to no alternative treatment options, intentional replantation with extraoral fragment bonding as part of the procedure has been proposed (Rosen et al 2018). A special adhesive resin containing 4‐methacryloxyethyl trimellitate anhydride/methyl methacrylate‐tri‐n‐butyl borane (4‐META/MMA‐TBB) was used to bond the fragments (Hayashi et al 2002, 2004, Nizam et al 2016, Sugaya et al 2016).…”
Section: Clinical Proceduresmentioning
confidence: 99%
“…More recent reports have used intentional replantation to enable extraoral bonding of teeth with vertical root fractures (Hayashi et al 2002, 2004, Nizam et al 2016, Sugaya et al 2016, Okaguchi et al 2018, Rosen et al 2018) or to treat teeth considered as having a periodontally hopeless prognosis (Hou et al 2016, Solakoglu & Filippi 2017, Saida et al 2018).…”
Surgical extrusion is defined as the procedure in which the remaining tooth structure is repositioned at a more coronal/supragingival position in the same socket in which the tooth was located originally. Intentional replantation is defined as the deliberate extraction of a tooth and after evaluation of root surfaces, endodontic manipulation and repair, placement of the tooth back into its original position. Tooth autotransplantation is defined as the transplantation of an unerupted or erupted tooth in the same individual, from one site to another extraction site or a new surgically prepared socket. The advent of titanium implant rehabilitation has reduced the use of these treatments in day‐by‐day clinical practice; however, the re‐emerging trend to conserve and preserve natural sound tissues has led to a rediscovery of these treatments. All three distinct surgical methods are closely related, as they act to treat teeth that cannot be predictably treated using other more conventional procedures in endodontics, periodontics and restorative dentistry. Furthermore, these procedures share the same treatment approach and include the atraumatic extraction of a tooth, visual inspection of the tooth/root and its subsequent replantation. The clinical procedures for surgical extrusion, intentional replantation and tooth autotransplantation treatment have undergone several changes in recent years, and currently, there are no clear clinical treatment protocols/guidelines available. The clinician should be aware of the outcome of these treatments. Hence, the aim of this narrative review is to provide the background, clinical procedures and outcomes of surgical extrusion, intentional replantation and tooth autotransplantation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.