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Objective <p>To evaluate the clinical outcomes, periodontal ligament (PDL) healing, and complication rates associated with Intermittent Oxygenation Technique (IOT), a staged reoxygenation protocol designed to preserve PDL vitality on the root surface during intentional replantation (IR).</p> Materials and methods <p>Forty mature permanent teeth from 39 patients underwent intentional replantation using IOT between 2020 and 2024. The protocol introduces intermittent replantation periods during extraoral procedures to restore oxygenation and nutrient diffusion to PDL cells on the root surface. Clinical and radiographic follow-up was performed for at least 12 months (mean: 2.7 years). Primary outcomes included the incidence of ankylosis and replacement resorption. Frequentist binomial statistics and Bayesian Beta–Binomial models were applied to estimate the true complication rate.</p> Results <p>No cases of ankylosis or replacement resorption were detected (0/40). The Clopper–Pearson 95% CI yielded an upper bound of 9.5%. Bayesian analysis demonstrated substantially lower credible upper bounds: 5.5% (Jeffreys prior), 6.6% (conservative prior), and 6.3% (literature-informed prior). Subgroup analysis (&lt; 15&#xa0;min vs. ≥ 15&#xa0;min extraoral time) revealed identical outcomes.</p> Conclusion <p>IOT may significantly reduce the risk of ankylosis and replacement resorption by mitigating PDL hypoxia through staged reoxygenation. Bayesian modelling strongly suggests that the true complication rate lies in the low single digits, substantially below historical values for traditional IR.</p>

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Ankylosis and external root resorption following intentional replantation using intermittent oxygenation technique: a Bayesian observational study

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Dina Abdellatif,
  • Alfredo Iandolo,
  • Turgut Selim Ipci,
  • Sarah De Fontaine,
  • Sara Mancino,
  • Mariangela Cernera,
  • Gianrico Spagnuolo,
  • Davide Mancino

摘要

Objective

To evaluate the clinical outcomes, periodontal ligament (PDL) healing, and complication rates associated with Intermittent Oxygenation Technique (IOT), a staged reoxygenation protocol designed to preserve PDL vitality on the root surface during intentional replantation (IR).

Materials and methods

Forty mature permanent teeth from 39 patients underwent intentional replantation using IOT between 2020 and 2024. The protocol introduces intermittent replantation periods during extraoral procedures to restore oxygenation and nutrient diffusion to PDL cells on the root surface. Clinical and radiographic follow-up was performed for at least 12 months (mean: 2.7 years). Primary outcomes included the incidence of ankylosis and replacement resorption. Frequentist binomial statistics and Bayesian Beta–Binomial models were applied to estimate the true complication rate.

Results

No cases of ankylosis or replacement resorption were detected (0/40). The Clopper–Pearson 95% CI yielded an upper bound of 9.5%. Bayesian analysis demonstrated substantially lower credible upper bounds: 5.5% (Jeffreys prior), 6.6% (conservative prior), and 6.3% (literature-informed prior). Subgroup analysis (< 15 min vs. ≥ 15 min extraoral time) revealed identical outcomes.

Conclusion

IOT may significantly reduce the risk of ankylosis and replacement resorption by mitigating PDL hypoxia through staged reoxygenation. Bayesian modelling strongly suggests that the true complication rate lies in the low single digits, substantially below historical values for traditional IR.