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Intentional replantation is a method to salvage teeth, especially in cases where orthograde re-treatment or apical surgery cannot be performed because of anatomical constraints and limited access. Techniques of intentional replantation have evolved to enhance clinical outcomes. The purpose of this case series, together with a narrative literature review, is to emphasize its importance, indications, contraindications, associated risks, success, and consideration as a treatment option as an alternative to extraction.
CPD/Clinical Relevance: This article discusses the advantages, disadvantages, indications, contraindications and techniques for intential replantation.
Article
Orthograde root canal treatment is the preferred option to treat pulpal or peri-apical pathology.1 However, if the symptoms fail to resolve despite optimum non-surgical root canal treatment and subsequent non-surgical re-treatment, then apical surgery, which is the next indicated option, has to be carried out to salvage teeth. Despite the high success rates of apical surgery, its execution may be challenging in some teeth, especially in the molar region, because of anatomical constraints.1 Therefore, intentional replantation may be an alternative treatment option for some of these cases.2,3
Intentional replantation is defined as extracting the tooth, resecting the root ends, followed by sealing with appropriate root-end filling material and replacement of the tooth back into its socket.4 This technique was first practiced by Ambrose Pare in the 16th century, and Pierre Fauchard during the 18th century, to salvage a tooth that was extracted accidentally.5,6 Since then, intentionally carrying out this technique has been reported in various case studies.7,8 With time, the technique of intentional replantation has been modified to enhance its clinical outcomes.7,8 It is a one-stage treatment to preserve the patient's aesthetics, as well as to maintain the alveolar bone.9
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