Clinical Outcomes after Intentional Replantation of Periodontally Involved Teeth

Introduction: Periodontal involvement has been thought to be a contraindication for intentional replantation. This retrospective study aimed to assess clinical outcomes after intentional replantation of teeth with periodontal involvement and to explore potential predictors of outcomes. Methods: Teeth with a history of intentional replantation between March 2000 and December 2014 and with 1 or 2 preoperative periodontal pockets >= 6mm among 6 sites evaluated per tooth were included. A total of 103 teeth were included, and 74 teeth were followed up for more than 6 months. Outcomes were assessed as improved (a decrease in the number and depths of periodontal pockets and the size of periapical radiolucency and no external root resorption or sign/symptoms) or failed. Data were analyzed with Kaplan-Meier survival analysis and a Cox proportional regression model. Results: Cumulative improved rates declined from 89% at 1 year to 68% at 4 years. A Cox proportional regression model identified the patient's age (P=.049; hazard ratio, 2.552) and the, number of preoperative periodontal pockets with a depth a >= 6 mm (P =.041; hazard ratio, 2.523) as predictors of outcomes in the replantation of periodontally involved teeth. Conclusions: Periodontal involvement is not an absolute contraindication to intentional replantation. The teeth with 1 preoperative periodontal pocket >= 6mm and the subjects aged <= 40 years had 2.5 times and 2.6 times lower probability of failure, respectively, than the teeth with 2 pockets and the subjects aged >40 years. Therefore, these factors need to be carefully considered for intentional replantation.