Professional Documents
Culture Documents
1971 F. N. T. Monrour
1971 F. N. T. Monrour
Fig. 1.-Maxillary anterior teeth of a n experi- Fig. 2.-Wrought stainless steel s lint
mental animal immediately prior to reim- ligated in position on the m a x i z a r y
plantation, showing t h e tooth form and t h e anterior teeth.
selected s t a g e of development.
teeth presented less difficulty with t h e pro- support, and ( i i ) the active development of the
cedure under trial conditions. The degree of teeth retained t h e presence of immature tissues
primary tissue damage on removal of a tooth capable of more rapid differentiation and
for reimplantation i s of the utmost importance repair.
in influencing t h e success of this procedure. Following the successful removal of the
The time selected for reimplantation was selected experimental teeth, the reimplantation
when the maxillary incisor roots had reached procedure took one of two forms: ( i ) imme-
approximately two-thirds their completed for- diate reimplantation, and ( i i ) delayed reim-
mation (Fig. 1). plantation.
This ensured that: ( i ) t h e teeth possessed I n the delayed reimplantation t h e extracted
open apices but with adequate root length for teeth were placed in sterile normal isotonic
Australian Dental Journal, August, I97 I 229
does not continue after the formation of osteo- likely that the proliferating neural elements
dentine until there i s regeneration of the from the periapical area followed the course of
odontoblastic layer, thus favouring the theory the arterioles seen in the apical region of the
of redifferentiation of the odontoblasts. Pulp.
I n this investigation i t was clearly seen that, I n a morphological study of this kind definite
following traumatic interruption of the odonto- limitations were experienced. It was possible
blastic activity by extraction and reimplanta- to observe the biological behaviour in terms
tion, these cells, prior to degeneration, continue of: type of reaction, time of onset, duration,
to form a deposit of tubular or reparative den- and the final result. I t was, however, impos-
tine. There was then oessation of deposition of sible to determine why this occurred and what
any mineralized tissues upon death of the initiating forces were present. This study has
original pulp. I t was not until the coronal highlighted the desirability to parallel such
advance of the replacement tissues from the an investigation with the use of specific pro-
apex, with progressive maturation and the dif- cedures, such as histochemical analysis, in
ferentiation of osteoblast-like cells, that any describing the biological processes involved in
further deposit waa observed. These productive the vital reimpla.ntation of teeth.
cells were differentiated from the flbrous Concluslon
replacement tissues and probably from the I t is readily recognized in this preliminary
primative fibroblasts in this tissue, and were investigation that successful vital reimplanta-
responsible for the deposition of osteo-dentine. tion is a possibility. Also, there is no doubt
In the cases where a n odontoblast-like layer that in most successful cases of reimplantation
of cells was identified a t 14 and 84 days after of extracted teeth, complete mineralization of
reimplantation, this was situated on a wall of the pulp chamber will eventually occur. It is
tubular dentine with no osteo-dentine present, possible, however, that while the tooth will
suggesting recovery rather than redifferentia lose its pulp, i t retains much of the vital
tion of these cells. character and acceptance which must be lost in
The atypical extension of the growth of the root-filled reimplanted teeth.
root by the extensive deposition of cellular No rationale for the successful clinical
cementum about the apex, was observed soon management of teeth for reimplantation can
after t h e disintegration of the disrupted be suggested due to the many variants involved
Hertwig's root sheath. There must exist some such as the stage of development, the extra-oral
initiating forces requiring the continued period, primary trauma, and contamination.
growth of the root irrespective of the presence However, the results of this study would
of an intact Hertwig's root sheath. These forces indicate that, owing to the considerable
may be associa,ted with continued eruption of recovery potential of the pulp in cases of mini-
the teeth, or possibly the inbuilt potential of mal trauma, there is the distinct possibility of
the developing tisues of the periodontium. A successful surgical reimplantation and re-
combination of these factors probably operated positioning of teeth.
and was influenced by the functional require-
ments of the reimplanted teeth. Summary
The reimplantation of teeth with the reten-
Although regeneration of neural elements
tion of vital characteristics was performed in
was observed in the pulpal replacement tissues the incisor teeth in dogs.
late in the observation period, no significant
The procedure was varied only in respect of
evidence waa found as t o their influence on
the time teeth were out of the socket.
the pattern of recovery or repair. It is most
It was observed that revitalization of the
elm Nordenram. A.-Auto transplantation of teeth. pulpal tissues was a possibility and where it
A clinical and experimental investigation. Acta.
Odont. Scand., 21, 13-76, suppl., 33, 1-138 1963. did not occur the pulpal tissues underweiit
(17) Tnmlin. A. J.-ReimDlantation of four imuacted
.. -->port of a case. Oral-Surg., degeneration, and were replaced by tissues
March) 1966.
Skielle;, V.-Follow-up study which underwent differentiation and osteoid
of teeth redanted after accidental loss. Acta material was deposited on the walls of the pulp
Odont.--Scaid.. 17 : 503-509 (Dec.), 1959.
Fleming H. S.-The osteogenic tendency of chamber leading to its complete or partial
dentin; after formation in tooth germ trans- obliteration.
plants. Oral Surg., 6 : 1315-1324 (Nov.). 1953.
Amew. R. G.. and Fonz. C. C.-Histoloeic Dental College,
s'tuhies in experimental-' transplantation -of
teeth. Oral Surg., 9 : 1, 18-39 (Jan-), 1956. University of Queensland.
(a)Fona C.-Histoloaic studies of aUtOtranSDlanted Brisbane, 4000.
teeih. Int. Ass. Dent. Res. Abstr. 41: 112, 1963.