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

Plotino G, Abella Sans F, Duggal MS, Grande NM, Krastl G, Nagendrababu V, et al.

Int Endod J, 2020 Dec;53(12):1636-1652.
PMID: 32869292 DOI: 10.1111/iej.13396

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.
Current Assessment of Reciprocation in Endodontic Preparation: A Comprehensive Review-Part I: Historic Perspectives and Current Applications

Grande NM, Ahmed HM, Cohen S, Bukiet F, Plotino G

J Endod, 2015 Nov;41(11):1778-83.
PMID: 26514866 DOI: 10.1016/j.joen.2015.06.014

During the evolution of mechanical instrumentation in endodontics, an important role has been played by reciprocating stainless steel files using horizontal rotational, vertical translational, or combined movements. These kinds of systems are still in use mainly as an accessory to help in the first phases of the treatment.
Current Assessment of Reciprocation in Endodontic Preparation: A Comprehensive Review--Part II: Properties and Effectiveness

Plotino G, Ahmed HM, Grande NM, Cohen S, Bukiet F

J Endod, 2015 Dec;41(12):1939-50.
PMID: 26480824 DOI: 10.1016/j.joen.2015.08.018

Many reciprocating file systems (RFs) have recently been introduced. This article reviews the properties, effectiveness, and clinical outcomes of the RFs.
Influence of Negotiation, Glide Path, and Preflaring Procedures on Root Canal Shaping-Terminology, Basic Concepts, and a Systematic Review

Plotino G, Nagendrababu V, Bukiet F, Grande NM, Veettil SK, De-Deus G, et al.

J Endod, 2020 Jun;46(6):707-729.
PMID: 32334856 DOI: 10.1016/j.joen.2020.01.023

INTRODUCTION: Negotiation, glide path, and preflaring are essential steps in root canal shaping procedures. This report aimed to discuss the terminology, basic concepts, and clinical considerations of negotiation, glide path, and preflaring procedures and the influence of these steps on root canal shaping.
METHODS: This systematic review was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol has been registered with the International Prospective Register of Systematic Reviews (number CRD42019127021). A comprehensive literature search was performed by 2 independent reviewers using a selected search strategy in 2 electronic databases (PubMed and Scopus) until January 28, 2019. A further search was performed manually in endodontic journals. Studies investigating or comparing at least 1 shaping property resulting from root canal instrumentation with a glide path or preflaring in human extracted teeth or clinical studies were included.
RESULTS: The literature shows that the definition of glide path and preflaring procedures remains controversial, which requires an elaboration in the American Association of Endodontists' Glossary of Endodontic Terms. After the removal of irrelevant and duplicated articles, 98 articles were included. The impact of glide path preparation and preflaring on working length determination, apical file size determination, canal transportation, separation of endodontic files, shaping time, dentinal microcrack formation, and extrusion of debris was discussed. Because of heterogeneity among the included studies, quantitative synthesis was not performed for most of the parameters.
CONCLUSIONS: An evidence-based guideline is needed to define and correlate the basic concepts and current applications of each step of contemporary advancements in root canal instruments. Glide path preparation reduces the risk of debris extrusion, has no influence on the incidence of dentinal crack formation, and improves the preservation of the original canal anatomy. The creation of a glide path may have no impact on Reciproc files (VDW, Munich, Germany) in reaching the full working length. Preflaring increases the accuracy of working length determination. Further randomized clinical trials are required to evaluate the effect of a glide path and preflaring on root canal treatment outcomes.