Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysis
Abstract Background Intentional replantation (IR) includes extraction, subsequent treatment, and replantation of teeth. It is regarded as a final strategy to preserve teeth affected by periapical periodontitis. This review aims to evaluate the overall prognosis and key prognostic factors of IR for p...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12903-025-06583-1 |
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| author | Baotian Zhang Liandi Cheng Xiangjin Deng Yutao Xiong Wei Liu Wei Zeng Wei Tang Chang Liu |
| author_facet | Baotian Zhang Liandi Cheng Xiangjin Deng Yutao Xiong Wei Liu Wei Zeng Wei Tang Chang Liu |
| author_sort | Baotian Zhang |
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| description | Abstract Background Intentional replantation (IR) includes extraction, subsequent treatment, and replantation of teeth. It is regarded as a final strategy to preserve teeth affected by periapical periodontitis. This review aims to evaluate the overall prognosis and key prognostic factors of IR for periapical periodontitis teeth. Methods Ten databases (Ovid MEDLINE, Ovid Embase, etc.) and two registers were searched up to June 2024. Two independent review authors selected and identified prognostic studies (both prospective and retrospective studies) involving patients with periapical periodontitis teeth undergoing IR, reporting on success and survival rates, and factors influencing outcomes. Then, two independent review authors extracted the characteristics of the included studies and assessed the bias using the QUIPS tool. Meta-analyses were undertaken wherever appropriate. Results A total of 39 studies (49 reports) with 2305 teeth were included in this review. 31 studies were judged as high risk of overall bias while the other eight at moderate risk. For overall prognosis, meta-analyses showed a pooled success rate of 0.78 (95% CI 0.70 to 0.84) and pooled survival rate of 0.89 (95% CI 0.85 to 0.93). For prognostic factors, survival rate ratio (SRR) of age was 0.73 (95% CI 0.53 to 0.99, p = 0.048), and SRR of combined periodontal-endodontic lesions (CPEL) was 0.80 (95% CI 0.67 to 0.95, p = 0.001). Discussion Results indicated that age and CPEL were significant factors influencing the success rate of IR, thereby supporting its clinical applicability in managing periapical periodontitis. The 39 cohort studies included in this review provided robust evidence for identifying the overall prognosis and key prognostic factors, which were the primary objectives of this study. However, the absence of large-sample cohort studies (both prospective and retrospective) reduces the reliability of the conclusions drawn in this review. Moreover, the observed variability across studies emphasizes the need for standardized protocols and further research to enhance consistency and reliability. Graphical Abstract |
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| institution | Kabale University |
| issn | 1472-6831 |
| language | English |
| publishDate | 2025-07-01 |
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| series | BMC Oral Health |
| spelling | doaj-art-24ba05fe4f55407bbf85e6802e07ea582025-08-20T03:46:29ZengBMCBMC Oral Health1472-68312025-07-0125111410.1186/s12903-025-06583-1Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysisBaotian Zhang0Liandi Cheng1Xiangjin Deng2Yutao Xiong3Wei Liu4Wei Zeng5Wei Tang6Chang Liu7State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityAbstract Background Intentional replantation (IR) includes extraction, subsequent treatment, and replantation of teeth. It is regarded as a final strategy to preserve teeth affected by periapical periodontitis. This review aims to evaluate the overall prognosis and key prognostic factors of IR for periapical periodontitis teeth. Methods Ten databases (Ovid MEDLINE, Ovid Embase, etc.) and two registers were searched up to June 2024. Two independent review authors selected and identified prognostic studies (both prospective and retrospective studies) involving patients with periapical periodontitis teeth undergoing IR, reporting on success and survival rates, and factors influencing outcomes. Then, two independent review authors extracted the characteristics of the included studies and assessed the bias using the QUIPS tool. Meta-analyses were undertaken wherever appropriate. Results A total of 39 studies (49 reports) with 2305 teeth were included in this review. 31 studies were judged as high risk of overall bias while the other eight at moderate risk. For overall prognosis, meta-analyses showed a pooled success rate of 0.78 (95% CI 0.70 to 0.84) and pooled survival rate of 0.89 (95% CI 0.85 to 0.93). For prognostic factors, survival rate ratio (SRR) of age was 0.73 (95% CI 0.53 to 0.99, p = 0.048), and SRR of combined periodontal-endodontic lesions (CPEL) was 0.80 (95% CI 0.67 to 0.95, p = 0.001). Discussion Results indicated that age and CPEL were significant factors influencing the success rate of IR, thereby supporting its clinical applicability in managing periapical periodontitis. The 39 cohort studies included in this review provided robust evidence for identifying the overall prognosis and key prognostic factors, which were the primary objectives of this study. However, the absence of large-sample cohort studies (both prospective and retrospective) reduces the reliability of the conclusions drawn in this review. Moreover, the observed variability across studies emphasizes the need for standardized protocols and further research to enhance consistency and reliability. Graphical Abstracthttps://doi.org/10.1186/s12903-025-06583-1Tooth replantationEndodonticsPeriapical periodontitisTooth ankylosisSystematic reviewEvidence-based medicine |
| spellingShingle | Baotian Zhang Liandi Cheng Xiangjin Deng Yutao Xiong Wei Liu Wei Zeng Wei Tang Chang Liu Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysis BMC Oral Health Tooth replantation Endodontics Periapical periodontitis Tooth ankylosis Systematic review Evidence-based medicine |
| title | Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysis |
| title_full | Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysis |
| title_fullStr | Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysis |
| title_full_unstemmed | Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysis |
| title_short | Prognosis of intentional replantation for periapical periodontitis teeth: a systematic review and meta-analysis |
| title_sort | prognosis of intentional replantation for periapical periodontitis teeth a systematic review and meta analysis |
| topic | Tooth replantation Endodontics Periapical periodontitis Tooth ankylosis Systematic review Evidence-based medicine |
| url | https://doi.org/10.1186/s12903-025-06583-1 |
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