J Periodontal Implant Sci.  2017 Dec;47(6):352-362. 10.5051/jpis.2017.47.6.352.

Periodontal wound healing following reciprocal autologous root transplantation in class III furcation defects

• Takeuchi N
• Shirakata
• Shinohara
• Sena K
• Noguchi K

• KMID: 2399741
• DOI: http://doi.org/10.5051/jpis.2017.47.6.352

Abstract

PURPOSE
Furcation involvement in the molars is difficult to treat, and has been recognized as a risk factor for tooth loss. Although periodontal regenerative therapies, including guided tissue regeneration and various types of bone grafts, have been applied to furcation defects, the effects of these treatments are limited, especially in large class III furcation defects. The purpose of this pilot study was to investigate the effect of reciprocal autologous root transplantation on periodontal wound healing and regeneration in class III furcation defects in dogs.
METHODS
Furcation defects (7 mm wide and 6 mm high) were surgically created after root separation of the unilateral third and fourth premolars in 4 dogs. Eight furcation defects were randomized to receive either reciprocal autologous root transplantation (test) or no further treatment (control). In the test group, the mesial and distal roots were transplanted into the distal and mesial extraction sockets, respectively. The animals were sacrificed 10 weeks after surgery for histologic evaluation.
RESULTS
The healing pattern in the control group was characterized by extensive collapse of the flap and limited periodontal regeneration. New bone formation in the test group (3.56±0.57 mm) was significantly greater than in the control group (0.62±0.21 mm). Dense collagen fibers inserting into the residual cementum on the transplanted root surfaces were observed in the test group. Slight ankylosis was observed in 2 of the 4 specimens in the test group on the mesiodistal sides where the root-planed surfaces faced the existing bone. Root resorption (RR) was detected in both the control and test groups.
CONCLUSIONS
Within the limits of this study, it can be concluded that reciprocal autologous root transplantation was effective for bone regeneration in class III furcation defects in dogs. However, further studies are required to standardize the approach in order to prevent unwanted RR prior to clinical application.

Keyword

Animal models; Histology; Periodontal diseases; Periodontal ligament; Wound healing

MeSH Terms

Animals
Ankylosis
Bicuspid
Bone Regeneration
Collagen
Dental Cementum
Dogs
Furcation Defects*
Guided Tissue Regeneration
Models, Animal
Molar
Osteogenesis
Periodontal Diseases
Periodontal Ligament
Pilot Projects
Regeneration
Risk Factors
Root Resorption
Tooth Loss
Transplants
Wound Healing*
Wounds and Injuries*
Collagen

Figure

• 

  Figure 1 Clinical overview of the surgical procedure. (A) Following root separation, a class III furcation defect was prepared. The root surface adjacent to the defect was planed with curettes to remove the cementum and PDL. (B and C) Reference notches were made on the root surfaces at the deepest point of the defects and at the CEJ. (D) The separated roots were extracted and the sockets were prepared. (E) The mesial root was transplanted to the distal extraction socket and the distal root was transplanted to the mesial socket in the same direction. (F) After the mucoperiosteal flap was coronally repositioned and sutured, transplanted roots were fixed with cobalt-chromium wire by dental adhesive resin cement. PDL: periodontal ligament, CEJ: cementoenamel junction.

• 

  Figure 2 Schematic illustration of the landmarks used for histometric measurements in the (A) control (no treatment) and in the (B) test (reciprocal autologous root transplantation) group. CEJ: cementoenamel junction, DH: defect height, N1: apical notch, N2: coronal notch, NB: new bone formation, RD: root distance.

• 

  Figure 3 Representative photomicrographs in the control group. (A) Overview of the class III furcation defects (scale bar=2 mm). (B) Higher magnification of the framed area in (A) (scale bar=100 μm). (C) Higher magnification of the framed area in (A) (scale bar=100 μm), toluidine blue staining. N1: apical notch, N2: coronal notch, NB: new bone formation, JE: junctional epithelium.

• 

  Figure 4 Representative photomicrographs in the test (reciprocal autologous root transplantation) group. (A) Overview of the class III furcation defects (scale bar=2 mm). (B) Higher magnification of the framed area in (A) (scale bar=100 μm). (C) Higher magnification of the framed area in (A) (scale bar=100 μm). (D) Higher magnification of the framed area in (A) (scale bar=100 μm), toluidine blue staining. N1: apical notch, N2: coronal notch, CEJ: cementoenamel junction, NB: new bone formation, RR: root resorption, ANK: ankylosis.

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