European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation: European Society of Endodontology developed by.

This European Society of Endodontology (ESE) position statement on surgical extrusion, intentional replantation and tooth autotransplantation represents the consensus of an expert committee, convened by the ESE. A narrative review in the International Endodontic Journal (Plotino et al. 2020, international Endodontic Journal, 53, 1636-52) formed the basis for the position statement. The review provided detailed information on the background, clinical procedures and the outcome of surgical extrusion, intentional replantation and tooth autotransplantation techniques. The aim of the current statement is to summarize the best available evidence on these clinical techniques to provide appropriate clinical guidance to undergraduate and postgraduate students, dental practitioners, clinical teachers and researchers. The current position statement will be updated by the ESE periodically to reflect new evidence as it becomes available to provide the most current treatment guidance for clinical practice.

Clinical procedures and outcome of surgical extrusion, intentional replantation and tooth autotransplantation - a narrative review.

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.

Successful pulp revascularization of an autotransplantated mature premolar with fragile fracture apicoectomy and plasma rich in growth factors: a 3-year follow-up.

AIM: This case report demonstrates a positive outcome of the adjuvant use of fragile fracture (FF), which is a technique used to harvest dental pulp stem cells (DPSCs), and platelet-rich plasma (PRP) in a mandibular premolar (tooth 44) with a completely formed root that was transplanted into a surgically created socket and which maintained pulp vitality and function. SUMMARY: After virtual surgical planning, a 3D tooth replica of tooth 44 was fabricated. A surgical socket was created in the position of tooth 14; then, tooth 44 was extracted and the root dentine was abraded using a turbine diamond bur 3 mm from the apex until a circular groove was prepared around the outer circumference of the root; and then, an FF was performed without damaging the pulp tissue. PRP was placed in the socket, after which the donor tooth was inserted in the recipient area. At 2 weeks post-treatment, orthodontic traction was applied. At 3-year follow-up, the tooth had adequate alignment and was asymptomatic. Response to pulp testing was positive, and the presence of pulp canal obliteration was observed as a sign of pulpal healing. KEY LEARNING POINTS: Autotransplantation is a good alternative for replacing missing teeth, with repair of tissues and pulp revascularization. Revascularization of an autotransplanted mature tooth using the fragile fracture technique and PRP scaffold is a feasible option and might have positive effects on the long-term outcome of the procedure. Including completely formed teeth as donors in autotransplantation, maintaining vitality and their functions is an option that warrants further study.

Aplicación de la tomografía computarizada de haz cónico en el manejo endodóncico de un molar superior en forma de C / Management of a C-shaped maxillary molar: three-dimensional analysis with cone beam computed tomography

Se presenta un caso de un tratamiento endodóntico de un primer molar superior derecho con una morfología radicular atípica en forma de C. Mediante tomografía computarizada de haz cónico (TCHC) se evidenció la fusión de los conductos palatino y distovestibular en una única raíz. En el artículo se describe la importancia de la correcta identificación de esta variación anatómica mediante los distintos métodos imagenológicos. Se revisa también la literatura respecto a la prevalencia de los molares superiores en forma de C, y el reto que supone en relación a la preparación químico-mecánica y a la obturación tridimensional

This clinical case presents an endodontic treatment of a C-shaped right maxillary first molar which represents an unusual root morphology. The cone beam computed tomography (CBCT) shows a complete fusion of the distobuccal and palatine canals in a single root. The article describes the importance of performing an adequate identification of this complex anatomy using different imaging techniques. It also reviews the literature regarding the prevalence of maxillary molars with a C-shape configuration, the challenge concerning chemical and shaping preparation and also the root canal filling

Retratamiento endodóntico de un primer molar inferior con gran lesión perirradicular: control a los 3 años mediante tomografía computarizada de haz cónico / Endodontic retreatment of a mandibular first molar with a large periradicular lesión: 3 year follow-up using cone beam computed tomography

Se presenta un caso de retratamiento endodóntico de un primer molar inferior con una gran lesión perirradicular. Se realiza un control de los 3 años mediante radiografías periapicales y una tomografía computarizada de haz cónico (TCHC) y se observa una completa curación perirradicular. En el artículo se describe la importancia de realizar una correcta preparación química y mecánica para la eliminación de la periodontitis apical. Se revisa también la literatura respecto al porcentaje de éxito de los retratamientos endodónticos, y se detalla la eficacia de la TCHC en la detección de periodontitis apical (AU)

The clinical case presents an endodontic retreatment of a mandibular first molar with a large periradicular lesión. Follow-up was performed at 3 years using periapical radiographs and cone bean computed tomography (CBCT) confirming complete periradicular healing. The article describes the importance of adequate chemical and shaping for the healing of apical periodontitis. It also reviews the literature regarding the success rate of endodontic retreatment, and addresses CBCT accuracy in detecting apical periodontitis (AU)