Incidence of Root Resorption after the Replantation of Avulsed Teeth: A Meta-analysis

• Published in: Journal of endodontics Vol. 44; no. 8; pp. 1216 - 1227
• Main Authors: Souza, Beatriz Dulcineia Mendes, Dutra, Kamile Leonardi, Kuntze, Morgane Marion, Bortoluzzi, Eduardo Antunes, Flores-Mir, Carlos, Reyes-Carmona, Jessie, Felippe, Wilson Tadeu, Porporatti, André Luís, De Luca Canto, Graziela
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2018
• Subjects: Dentistry; Humans; Incidence; Review; root resorption; Root Resorption - epidemiology; Root Resorption - etiology; tooth avulsion; Tooth Avulsion - surgery; tooth injuries; Tooth Replantation; root resorption; tooth avulsion; Review; tooth injuries
• ISSN: 0099-2399; 1878-3554
• DOI: 10.1016/j.joen.2018.03.002

An avulsion injury is a serious trauma to pulp and periodontal tissues. After avulsion and replantation, teeth are at risk of infection and root resorption, which may affect treatment outcome and survival rate. Thus, the purpose of this systematic review was to evaluate the incidence of root resorption after the replantation of avulsed teeth.
Two reviewers searched 7 electronic databases for observational studies involving human subjects that evaluated the incidence of root resorption after tooth avulsion. Risk of bias (RoB) was evaluated using the Meta-Analysis of Statistics Assessment and Review Instrument, and the quality of available evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.
Of the 1507 articles, 23 met the inclusion criteria. A meta-analysis was conducted and showed that the incidence of internal root resorption was 1.2% (95% confidence interval [CI], 0.02–5.50). Regarding external root resorption, the incidence of surface root resorption was 13.3% (95% CI, 6.21–22.62), that of inflammatory root resorption was 23.2% (95% CI, 13.94–34.19), and that of replacement root resorption was 51.0% (95% CI, 40.10–62.00). Two studies presented a high RoB, 16 had a moderate RoB, and 11 had a low RoB. The overall level of evidence identified was very low.
The incidence of root resorption after avulsion and replantation in descending order was replacement root resorption > inflammatory root resorption > surface root resorption > internal root resorption.
1.This meta-analysis investigated the available evidence regarding root resorption (RR) after replantation of avulsed teeth.2.In general, the incidence of RR related to replantation of avulsed teeth is high.3.Specifically, the most common incident type of resorption was replacement RR followed by inflammatory RR, surface RR, and internal RR.