|ORIGINAL RESEARCH REPORT
|Year : 2016 | Volume
| Issue : 2 | Page : 88-89
Bone suturing as a new way for splinting of single standing molar tooth after intentional replantation: A technical note
Amin Rahpeyma1, Saeedeh Khajehahmadi2
1 Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
2 Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
|Date of Web Publication||4-Apr-2016|
Dental Research Center, Mashhad University of Medical Sciences, P.O. Box: 91735 984, Vakilabad Blvd, Mashhad
Source of Support: None, Conflict of Interest: None
Introduction: Single standing mandibular and maxillary teeth are difficult situations for splinting. Convectional splinting techniques that use wire only techniques or wire composite are not usable in this case. Method: Bone suture technique in a mandibular molar, directly through the socket and in the maxillary single standing molar through adjacent edentulous space was done for splinting after intentional replantation. Results: This method was effective in tooth splinting. Conclusion: Bone suture technique is valuable method for splinting after intentional replantation in the case of lone standing molar.
Keywords: Bone suture, intentional replantation, splinting
|How to cite this article:|
Rahpeyma A, Khajehahmadi S. Bone suturing as a new way for splinting of single standing molar tooth after intentional replantation: A technical note. J Clin Sci 2016;13:88-9
|How to cite this URL:|
Rahpeyma A, Khajehahmadi S. Bone suturing as a new way for splinting of single standing molar tooth after intentional replantation: A technical note. J Clin Sci [serial online] 2016 [cited 2021 Mar 8];13:88-9. Available from: https://www.jcsjournal.org/text.asp?2016/13/2/88/179683
| Introduction|| |
Intentional replantation is often the last option before tooth extraction in endodontically complicated tooth.  This procedure can be used instead of apical surgery in the second molar tooth with the thick buccal cortical plate. 
Splinting after intentional replantation is recommended if indicated.  Etching, wire composite, circumferential wiring, periodontal dressing, and suture material are recommended ways. ,,
Single standing molar teeth are difficult situations for splinting after intentional replantation. 
A new way that can solve this problem is presented in this article.
| Surgical technique|| |
After atraumatic tooth extraction; root end resection, preparation and filling was done outside of the oral cavity. In the mandibular molar socket by no. 8 round bur, 4 mm bellow the ridge crest a hole was created in the buccal cortical plate, over mucosally without the need for soft tissue flap reflection. The same procedure was repeated through the tooth socket with the lingual plate as the target.
A stainless steel 4-0 surgical soft wire was passed through these two holes, and the extracted tooth was replaced back into the socket. The lingual end of the wire was passed over the occlusal table between lingual cusps and tied in buccal aspect of the tooth. Finally, the occlusal contacts were checked. The other option when the occlusion is tight is turning the wire around the tooth and then twisting it in buccal aspect of the tooth [Figure 1].
|Figure 1: Bone suture technique for splinting in the mandibular first molar tooth with intact adjacent teeth. (a) Stainless steel wire is passed through the bony socket wall. (b) The wire is twisted in buccal aspect of replanted tooth and occlusion is checked. (c) Schematic picture. (d) The wire is turned around the tooth.|
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In the upper jaw with edentulous space just anterior to the replanted tooth, this technique can be used in modified form. A through and through hole in edentulous region mesial to the replanted tooth is created by round surgical bur. A stainless steel 4-0 surgical wire is passed through this hole and then twisted around the replanted tooth [Figure 2]. This wire should be removed one month after surgery.
|Figure 2: (a) Bone suture technique for splinting in maxillary single standing molar (periapical radiography). (b) Schematic picture|
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| Discussion|| |
After intentional replantation, if the adjacent teeth are present, the primary stability can be gained without any splint devices, but if indicated, appropriate splinting is necessary. In single standing molars, the splinting procedure became more difficult. Suggested ways in the articles are periodontal dressing,  or if previously fixed bridge is present then recement it.  Bone suture technique can be used effectively for stabilization of replanted single standing mandibular molars. These teeth have one mesial and one distal root, so the wire can pass between the roots. In maxillary molars, this technique cannot be used through the empty socket. Because of interference with palatal root after replantation, so the edentulous space anterior to the tooth is used for this purpose. This technique is also applicable in every mandibular molar tooth.
| Conclusion|| |
Bone suture technique is a way for splinting of single standing molar teeth after intentional replantation. It can solve the problem of splinting in this difficult clinical situation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Rouhani A, Javidi B, Habibi M, Jafarzadeh H. Intentional replantation: A procedure as a last resort. J Contemp Dent Pract 2011;12:486-92.
Peer M. Intentional replantation - A ′last resort′ treatment or a conventional treatment procedure? Nine case reports. Dent Traumatol 2004;20:48-55.
Wolcott J, Rossman LE. Intentional replantation of endodontically treated teeth: An update. Compend Contin Educ Dent 2003;24:68-72, 74.
Herrera H, Leonardo MR, Herrera H, Miralda L, Bezerra da Silva RA. Intentional replantation of a mandibular molar: Case report and 14-year follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:e85-7.
Tang PM, Chan CP, Huang SK, Huang CC. Intentional replantation for iatrogenic perforation of the furcation: A case report. Quintessence Int 1996;27:691-6.
Dryden JA, Arens DE. Intentional replantation. A viable alternative for selected cases. Dent Clin North Am 1994;38:325-53.
Benenati FW. Intentional replantation of a mandibular second molar with long-term follow-up: Report of a case. Dent Traumatol 2003;19:233-6.
Cowan RD, Addy NL, Ritchie GM, Myers TL. Intentional replantation of a removable partial denture abutment tooth: A case report. Quintessence Int 1992;23:33-7.
Din FM. Intentional replantation to prevent loss of an abutment tooth. Gen Dent 1987;35:39-41.
[Figure 1], [Figure 2]