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 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
 reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy
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reimplantation & transplantation /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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  1. REIMPLANTATION & TRANSPLANTATION www.indiandentalacademy.com
  2. REIMPLATATION:-introduction • Def:- may be defined as the replacement of a tooth into its natural socket. • Purpose:- a] following luxation or subluxation. b] after surgical extraction either in error or for the performing some procedure on the tooth outside the mouth. • Differences:- a) degree of contamination of tooth and the socket. b)length of time before reimplantation takes place. c)the extent of damage to the supporting tissue bone, periodontal membrane and gingiva. www.indiandentalacademy.com
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  4. • Incidence:- more common in children, where root formation is incomplete and periodontium is resilient. • Under these circumstances, even slight horizontal impact may result in total dislocation of tooth. • Playing fields and roads being at high risk. • Upper and lower anterior teeth being more common and others unless done intentionally. • Teeth accidentally extracted or luxated due to improper use of elevators. www.indiandentalacademy.com
  5. DIAGNOSIS AND ASSESSMENT • General assessment:- made from history a) time of accident is very important. b) site from which they are lost. c) radiographs including adjacent teeth that also may have been injured. d) missing or damaged teeth. e) accidental swallowing or inhaled teeth or embedded in lip or soft tissues must be considered. f) patients medical history – congenital heart conditions, rheumatic heart disceases, and blood dyscrasis etc., may contraindicate reimplantation. www.indiandentalacademy.com
  6. • Local assessment:a) great attention should be paid for supporting tissues, particularly the alveolar bone. b) fractured alveolar fragments which are well attached to the soft tissues maintaining blood supply should be considered. c) whether contaminated with saliva, with food and other debris. d) pieces of loose bone in the socket should be removed, bone loss from this cause or previous periodontal disease may contrindicate reimplantation. e) whether apical third of the root is retained apparently unmoved in the socket. www.indiandentalacademy.com
  7. STORAGE OF TEETH • AN AVULSED TOOTH IS BEST STORED IN PATIENTS SALIVA(2HR) • IT IS ADVISED TO WASH OFF A CONTAMINATED TOOTH WITH WATER GENTLY WITHOUT TOUCHING OR RUBBING THE ROOT PART AND TO BE KEPT UNDER THE TONGUE TILL PATIENT REPORTS FOR TREATMENT. • TOOTH CAN ALSO BE STORED IN STERILIZED CONTAINER IN ICE COLD NORMAL SALINE (PHYSIOLOGIC SALINE )OR MILK. • SOME PHARMCEUTICALS SUPPLY SPECIALLY PREPARED STORAGE MEDIA WHICH MIMIC THE CONDITIONS OF ORAL ENVIORNMENT. • SOME CASES WERE REPORTED WHERE SOME OTHER ODD STORAGE MEDIAS LIKE WATER, BRANDY, CULTURE MEDIA ETC WERE USED TO STORE TEETH. www.indiandentalacademy.com
  8. REIMPLANTATION:PROCEDURE CASE 1 • REPLANTATION OF 11 IN A 19YR OLD MAN, RADIOGRAPHIC EXAMINTION SHOWS NO SIGN OF FRACTURE OF ALVEOLAR SOCKET. • The tooth was retrived immediately after injury and kept moist in the oral cavity and then in Physiologic saline. www.indiandentalacademy.com
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  10. RINSING THE TOOTH • The tooth is examined for #’s, position of the level of Periodontal attachment and signs of contamination. • The tooth is rinsed with a stream of saline until all visible signs of contamination are removed. • The coagulum in the alveolar socket is flushed out using a stream of saline(RESORPTION). www.indiandentalacademy.com
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  12. REPLANTING OF THE TOOTH • The tooth is grasped by the crown with the forceps and partially replanted into the socket. • Replantation is completed by using a gentle finger pressure ,if any resistance is made the tooth should be removed and socket is inspected. • A straight elevator is then inserted into the socket and index finger is placed labially. Using lateral pressure, counter balance by finger pressure socket wall is repositioned www.indiandentalacademy.com
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  14. SPLINTING • Careful splinting should be done with the suitable technique. • As soon after injury as possible, antibiotic therapy should be instituted. • Suggested dosage : Penicillin 1mill IU immediately ,there after 2-4 mill IU daily for 4 days. • Good oral hygiene is absolute. • Splint removal and review should be done after 7 days to allow some functional movement of the replant in order to reduce/eliminate the risk of Ankylosis. www.indiandentalacademy.com
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  16. CASE 2 REPLANTING A TOOTH WITH AVITAL PDL • In this case 21 yr old man, the tooth has been kept dry for 24 hrs. • Total and reversible damage to PDL and PULP can be expected and severe contution of Alv Socket present. • Treat Plan: Delayed replantation (to allow healing of the socket). Treat of the root surface (to make it resistant to ANKYLOSIS). Endodontic therapy (to prevent inflammatory reaction). www.indiandentalacademy.com
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  18. TREATMENT OF THE ROOT SURFACE • The avulsed tooth was kept dry in a refrigerator until healing of the contused socket has taken place. • The root surface is rinsed and scraped clean of dead PDL and Pulp extripated. • Then treated with NaF sol, the goal of the therapy is to incorporate F ions into the dentin and cementum in order to protract the resorption process( 2.4 % NaF, acidulated to Ph 5.5 for 20 min). • Endodontic treatment done. www.indiandentalacademy.com
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  22. CONDITION OF THE SOCKET • After 3 weeks socket area and contused gingiva are healed. www.indiandentalacademy.com
  23. R REPLANTING THE TOOTH • The socket is evacuated with excavators and a surgical bur, the tooth is replanted after clensing with saline to remove excess F sol. www.indiandentalacademy.com
  24. SPLINTING • The tooth is splinted for 6 weeks in order to create a solid Ankylosis, in these cases where no PDL exists, ankylosis is the only healing modality. www.indiandentalacademy.com
  25. PULP HEALING AFTER REPLANTATION www.indiandentalacademy.com
  26. PDL HEALING AFTER REPLANTATION www.indiandentalacademy.com
  27. PULPAL HEALING RELATED TO DRY EXTRA ALVEOLAR TIME www.indiandentalacademy.com
  28. PDL HEALING RELATED TO DRY EXTRA ALV TIME www.indiandentalacademy.com
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  30. TRANSPLANTATION www.indiandentalacademy.com
  31. INDICATIONS • Def :- it is the transferal of a natural tooth from one site to another. • A) FAILURE OF TEETH TO ERUPT • B) TEETH LOST THROUGH TRAUMA • C) DENTAL DISCEASE www.indiandentalacademy.com
  32. REQUIREMENTS STABILITY OF THE RECIPIENT SITE - The recipient site must provide sufficient space for the crown( contralateral tooth check). - Too much space is not advisable because food impaction in early postoperative period may lead to infection. - The soft tissues of the gingivae should be helthy and free from periodontal discease. - The alveolar bone should be of sufficient volume to allow a socket to be prepared, esp., buccolingually and buccopalatally. A more serious contraindication is loss of vertical alv ht and soft tissue ht, which cannot be compensated satisfactorily. Position of Imp anatomic structures: Antral floor,floor of the nose and IAN are closely related structures which are deciding factors for the transplantation - www.indiandentalacademy.com
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  34. DONOR TOOTH • They are 4 types : -Autogenous tooth tranplant -Isogenic transplantation -Allogenic transplantation -Xenogenic transplantation www.indiandentalacademy.com
  35. AUTOGENOUS : • When a tooth is removed from one site and transferred to another site in the same individual • This is the most commonly used,where unerrupted, partially errupted tooth and roots are used. • The ideal stage of development is when roots are atleast 2/3 rds formed but their apices should still be opened, because they are easy to extract and after implantation they continue to grow. • The root should be straight, if they are hooked or widely divergent multiple roots, it’ll be difficult to extract or accommodate. www.indiandentalacademy.com
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  37. TOOTH GERM TRANSPLANTATION This has successfully been transplanted autogenously. The tooth when successfully operated continues to develop and errupt, the operation is infrequently performed because the Pts seldom presents as a problem requiring this treatment so early an age. The chief difficulty of this operation is the dissection of the tooth bud out of its natural site without damage to the enveloping soft tissues, and preparation of a suitable deep recepiant cavity within which it can develop. The transplant must be carefully protected from contamination by satisfactory closure. Usually carious first molor is replaced by the third molor tooth germ. www.indiandentalacademy.com
  38. ROOT TRANSPLANTATION • When root alone is to be used the crown may be retained for the purpose of immobilization, and cut of or prepared for an artificial crown later. • Some authors have transplanted single roots cut from other teeth and placed in the socket where they take without any form of fixation apart from sutures placed over them. ISOGENIC TRANSPLANTATION : • Made b/w two identical twins immediately, without any period of storage or delay,should present problems no different from those involved in autogenous transplants. www.indiandentalacademy.com
  39. ALLOGENIC TRANSPLANTS • When a tooth is removed from one individual and transferred to a second individual of the same species who is genetically dissimilar. • Today it is understood that teeth and dental tissues are antigenic and provoke immune response mainly from the Pulp & PDL. • This is established by the second set responses and the production of immunoblast in the regional lymph nodes draining the area. • The set back is of two types : 1)Initial set back 2)Later set back www.indiandentalacademy.com
  40. • However some authors demonstrated 80-85% of success for over 3 yrs. • The second danger is Introduction of infection from donors, such as Syphilis, Hepatitis B & AIDS. TOOTH BANKS • These are the storage areas of teeth with a view to subsequently implanting them. • They are stored or cultured teeth and some authors claim them to be less antigenic. • 3 METHODS OF TOOTH STORAGE Reduced temp, Tissue culture and Chemical coagulation. www.indiandentalacademy.com
  41. • In reduced temp storage the Cryo protective properties of Glycerol are used to bind water and so reduce dehydration denaturation. • To date the difficulty in establishing the banks is due to the short length of time for which teeth can be stored and the most obvious transplants still remains to be provoking the host immune response. XENOGENIC TRANSPLANTS • When a tooth from an individual of one species is transferred to another individual of another species. www.indiandentalacademy.com
  42. TRANSPLANT TECHNIQUE • Assessment of the Pt, Inspection of the site and proper medical history are to be done • The operation is performed under LA/GA. • The donor tooth should first be exposed and excised, unerrupted teeth must be extracted whole using the least force. • A large flap and often extensive bone removal is necessary to provide good access to free the crown and root over a large area • For an unerrupted canine, the palatal mucosa should be widely reflected and extensive removal of palatal bone is necessary to free the tooth. • The greatest care must be taken when using chisel and burs, not to engage the crown or root, even minor damage from these instruments can causewww.indiandentalacademy.com later resorption of the tooth
  43. • Then the tooth is left in its socket and soft tissue flap replaced to protect it. • Alternately it may be placed in the Pts own serum, which is prepared from 10 cu cm of blood taken on the morning which is centrifuged and added a suitable antibiotic, such as Penicillin/ Erythromycin, which is kept at body temp • The recepient socket may be then resonably prepared. • It is done using rose head and fissure burs, well irrigated with sterile saline. • In molar sockets the inter radicular bone should be removed to allow the new root to be freely accommodated www.indiandentalacademy.com
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  45. • To avoid repeatedly trying the fit with the tooth to be transplanted sterilized dummies made out of acrylic are used. • Always choosing one of slightly larger size so that it encourages loose rather than snug fit. • The root must never make a tight fit or need to be forcibly pushed or malletted home into the bone. • Occlusion is checked, ideally should just clear the occluding teeth in all excursions of the lower jaw,judicial grinding may also be advocated. www.indiandentalacademy.com
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  47. IMMOBILIZATON 1) Wiring 2)Adhesives 3)Splints 4)No Fixation www.indiandentalacademy.com
  48. WIRING • The tooth may be held in position by wiring it to one or both of the neighbouring teeth. • Disadvantages of Wiring are: 1)Gives minimal protection from occlusal forces. 2)It tends to loosen and allow the tooth to move. 3)Food debris gathers around the wires and can be forced up long axis of the tooth causing infection www.indiandentalacademy.com
  49. ADHESIVES • They have been to effect direct bonding by an acid etch technique followed by the application of an acrylic monomer or acrylic resin adhesive • Disadvantages : 1)The tooth may come adrift early on 2)Removal of adhesive from the teeth to which it may be strongly attached www.indiandentalacademy.com
  50. SPLINTS • These are cap splints made from silver, acrylic, or vacuum form. • Removal of splint can be a delicate procedure, in this respect acrylic splints held in place with rapid set ZnOE paste quite satisfactorily for one month yet easy to remove without any danger of disturbing the transplant. NO FIXATION • Some have suggested no fixation is required and tooth is clear of occlusal forces and has its crown firmly held b/w two adjacent teeth mainly in case of molar and pre-molar teeth. www.indiandentalacademy.com
  51. RESULTS IMMEDIATE FAILURES • This term is used to cover those which never take and virtually are removed with the splint. • This is mainly due to gross damage to the tissues, insufficient supporting bone, acute local infection, and food packing b/w cementum and bone due to poor closure and unsatisfactory immobilization. www.indiandentalacademy.com
  52. FAILURE IN FIRST TWO YRS • Of those teeth that appeared to have taken at the time the immobilization is removed pictures rejection later. • Most possible causes are traumatogenic occlusion, PDL infection. • These can be prevented by grinding and maintainance of oral hygiene in home and office. www.indiandentalacademy.com
  53. LATE FAILURE 1)Aesthetic criteria of normal size shape and colour and a good position in the dental arch. 2)Functional criteria, i.e their capability for effective mastication, space of indefinite maintainance, end of sharing in maintaining maxillary mandibular occlusal relationship. 3)Clinical & Radiographic criteria, i.e transplant should be free of Periapical and lateral PDL lesions, Pulp vital and of normal vascularity, and the tooth substance and supporting bone sound. www.indiandentalacademy.com
  54. RESORPTION 1)Min damage to PDL and cementum from instruments. 2)Immediate transfer of transplant. 3)Closure of soft tissues around the neck of the tooth. 4)Antibiotic cover 5)Good oral hygiene & PDL health. 6)Splint should be removed after 3-4 weeks. 7) Age of the Pt, best under 20 yrs. www.indiandentalacademy.com
  55. Revascularization after Cryo preservation &Autotransplantation of Immature &Mature Apicoectimised teeth by Wim laurey, shilde beele, Tissue bank university hospital, gent, belgium www.indiandentalacademy.com
  56. • This study is done on 16 teeth in 2 dogs, 8 teeth were removed and immediately transplanted to the contralateral position and 8 teeth were cryo preserved and transplanted one week later. • Results: 1)Teeth can revascularize after transplantation if the original pulp tissue is removed at the time of extraction. 2)There is no significant diff in the amount of revascularization b/w teeth stored and teeth transplanted immediately. 3)There is no difference in the ingrowth of the new pulpal tissue b/w matured apicoectamised teeth and immature teeth www.indiandentalacademy.com
  57. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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