Replanting severely damaged single-rooted teeth to try to save them and restore bone

Assessment of Treatment Outcomes and Alveolar Bone Changes Following Intentional Replantation of Hopeless Periodontally Involved Single-Rooted Teeth - A Pre-test, Post-test Interventional Study

This project will try intentional replantation to save single-rooted teeth judged hopeless because of chronic periodontitis in adults aged 18–70.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 45 (estimated)
• Ages: 18 Years to 70 Years
• Sex: All
• Sponsor: University of Fujairah (Academic / other)
• Locations: 1 site (Fujairah, Emirate of Fujairah)
• Trial ID: NCT06893107 on ClinicalTrials.gov

What this trial studies

This is a single-arm before-and-after interventional study where adults with single-rooted teeth considered hopeless from periodontic lesions undergo intentional replantation. Teeth are atraumatically extracted, handled extraorally for less than 15 minutes with possible root-end treatment, and replanted and splinted, followed by standard postoperative care. Outcomes include radiographic bone and periodontal tissue changes measured with CBCT at baseline and 9 months, clinical signs such as pain, swelling, and mobility, and patient-reported satisfaction and quality of life. Data collection combines clinical exams and imaging to compare status before and after the procedure.

Who should consider this trial

Good fit: Adults 18–70 with a single-rooted tooth judged hopeless from true periodontic lesions who have ≥50% radiographic bone loss, probing depth ≥5 mm, Grade III mobility of the targeted tooth, ASA class 1–2, and who prefer replantation and can attend follow-up visits.

Not a fit: Patients with vertical root fractures, prior failed intentional replantation, severe anatomic limitations, multi-rooted teeth, poor systemic health, or unwillingness to adhere to follow-up are unlikely to receive benefit from this procedure.

Why it matters

Potential benefit: If successful, this approach could allow some patients to keep teeth that would otherwise be extracted, improve local bone support and symptoms, and enhance oral-related quality of life.

How similar studies have performed: Previous case series and small cohort reports of intentional replantation have shown mixed but sometimes promising outcomes, but large randomized trials are lacking.

Eligibility criteria

Inclusion Criteria:

Patients meeting the specified criteria will be included in the study.

* The patients with American Society of Anesthesiologists physical status classification 1 and 2.
* Radiographic bone loss of at least 50% around the targeted tooth.
* Probing depth of at least 5 millimetres around the targeted tooth.
* Grade III mobility (extreme mobility) of the targeted tooth according to Miller's classification.
* Grade II mobility or less (minimal to slight increased mobility without functional impairment) of adjacent teeth.
* Distance between the targeted tooth and adjacent teeth less than 2 millimetres.
* Patient preference for tooth retention through intentional replantation over extraction.

Exclusion Criteria:

* Previous history of failed IR.
* Severe anatomical limitations in the treatment area.
* Unwillingness to adhere to follow-up protocols

Where this trial is running

Fujairah, Emirate of Fujairah

• Dental Clinic, College of Dentistry, University of Fujairah, — Fujairah, Emirate of Fujairah, United Arab Emirates (Recruiting)

Study contacts

• Principal investigator: Nabeel Ayappali Kalluvalappil, MDS — Lecturer, College of Dentistry, University of Fujairah, UAE, Zip Code 2202
• Study coordinator: Nabeel Ayappali Kalluvalappil, MDS

Conditions Chronic Periodontitis; Chronic periodontitis; Periodontally compromised tooth; Intentional replantation