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

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 12 months.

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.