The effect of intracanal Ledermix on root resorption of delayed-replanted monkey teeth

Abstract

Progressive root resorption is one of the common sequelae in replanted teeth, which is detrimental to their long-term prognosis. Ledermix paste, with its composition of triamcinolone acetonide and demethylclortetracycline, has been shown to inhibit inflammation and the associated hard tissue resorption. This study evaluated the effect of immediate intracanal Ledermix on root resorption of delayed-replanted monkey teeth. A total of 36 roots were root canal treated. For the experimental group, intracanal Ledermix was placed prior to extraction and replantation after 1-h bench dry. The positive control group was root filled and replanted after 1 h while the negative control group was root filled and replanted immediately. The monkeys were sacrificed after 12 weeks. The H&E histological tissue specimens were prepared and evaluated using a method modified from that of Andreasen's morphometric analysis, as favorable or complete healing and unfavorable healing, comprising inflammatory root resorption and replacement resorption. The results were analyzed using Kruskal-Wallis and Mann-Whitney U-tests as well as Wilcoxon signed ranks test. The negative control group produced highly significant favorable healing and unfavorable healing as compared to the Ledermix group (P = 0.000). The Ledermix group only showed significantly higher occurrence of complete healing (35.46%) compared to the positive control group (16.58%) (P = 0.037) but there were no significant differences in the inflammatory root resorption and replacement resorption. Nevertheless, when the latter two unfavorable healing patterns were combined, there was a significantly lower overall unfavorable healing in the Ledermix group (64.54%) when compared to the positive control group (83.43%) (P = 0.037). This unfavorable healing outcome in the Ledermix group, however, was not significantly different from the favorable healing outcome with the same treatment modality (P = 0.110).