Minimally Invasive Alternatives to Dental Extraction and Implant Placement

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Minimally Invasive Approaches in Endodontic Practice

Abstract

In recent decades, our understanding of the wound healing process following transplantation and replantation has significantly contributed to the successful outcome of these procedures. Carefully selected cases based on indications can make autotransplantation a sufficiently predictable treatment, with success rates ranging from 70% to 95% over 5 years. Regardless of whether donor teeth have an open or closed apex, favorable periodontal ligament (PDL) healing is fundamental to success. Ideal PDL healing occurs when the extracted tooth is replanted in its original recipient socket or in another one, in a short extraoral time, when most of PDL’s cells are still alive. Today, the combination of digital planning, experience, skill, and good judgment in case selection makes autotransplantation even more predictable.

Among other endodontic procedures, intentional replantation is useful to correct an evident endodontic failure in which a tooth is intentionally extracted, manipulated extraorally, and then replanted in its original site. This technique differs from surgical extrusion in that it entails placing the tooth at the original bone level without positioning it more coronally, as in surgical extrusion. In some cases, the clinician can combine these two techniques to improve both the restorability and the periapical condition of the tooth in question. However, it is worth noting that, to date, intentional replantation, autotransplantation, and surgical extrusion need more scientifically based evidence, including randomized controlled trials (RCTs). Needless to say, the clinician’s skill and expertise are key to the final results.

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Correspondence to Francesc Abella Sans .

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Abella Sans, F. (2021). Minimally Invasive Alternatives to Dental Extraction and Implant Placement. In: Plotino, G. (eds) Minimally Invasive Approaches in Endodontic Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-45866-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-45866-9_9

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