Periodontal healing following avulsion and replantation of teeth: a multi-centre randomized controlled trial to compare two root canal medicaments

Dent Traumatol. 2012 Feb;28(1):55-64. doi: 10.1111/j.1600-9657.2011.01053.x. Epub 2011 Oct 11.

Abstract

Background: Non-setting calcium hydroxide (Ultracal XS(®) ) is recommended by the International Association of Dental Traumatology as the initial medicament following avulsion and replantation for mature teeth. There is experimental evidence to suggest Ledermix(®) , placed as an alternative inter-visit dressing may improve periodontal healing.

Aim: This study investigated, using a multi-centre randomized controlled trial, the effect of two root canal medicaments, Ledermix(®) and Ultracal XS(®) , on periodontal healing of avulsed and replanted teeth.

Material and methods: Children were recruited if they fulfilled all inclusion criteria. Treatment followed a standardized protocol. Assessment of periodontal healing or ankylosis was made clinically and radiographically by an experienced, 'blinded', clinician at 12months.

Results: Over 200 patients were assessed for eligibility at five centres. Twenty-nine patients were eligible for inclusion. Final analysis involved 22 patients with 27 teeth. Ankylosis was detected in four of the 12 teeth in the Ledermix(®) group and nine of 15 in the Ultracal XS(®) group. No significant difference between medicaments was found in the proportion of teeth or patients showing periodontal healing.

Discussion: There was no significant difference in periodontal healing between the two medicaments at either a tooth or patient level. The numbers recruited fell short of an estimated power calculation. For patients meeting the inclusion criteria and completing the trial, periodontal healing was seen in 52% of teeth at the 12-month assessment between both groups. The only factor found to significantly influence the periodontal outcome was dry time.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Calcium Hydroxide / therapeutic use
  • Child
  • Demeclocycline / therapeutic use
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Periodontal Ligament / physiopathology*
  • Root Canal Irrigants / therapeutic use*
  • Root Canal Therapy / methods
  • Root Resorption / prevention & control
  • Single-Blind Method
  • Tooth Ankylosis / prevention & control
  • Tooth Avulsion / therapy*
  • Tooth Replantation / methods*
  • Treatment Outcome
  • Triamcinolone Acetonide / therapeutic use
  • Wound Healing / physiology

Substances

  • Drug Combinations
  • Root Canal Irrigants
  • UltraCal XS
  • Demeclocycline
  • Ledermix
  • Triamcinolone Acetonide
  • Calcium Hydroxide