Intentional Replantation - Small procedure, big benefits: A report of five cases

Abstract

Intentional replantation (IR) is a conservative endodontic procedure that may offer predictable results when conventional non-surgical endodontic treatment (NSET) or retreatment fails. The aim of the present report was to describe the management and outcomes of five cases of persistent apical periodontitis treated successfully with IR after failed NSET or retreatment. All the cases underwent IR involving atraumatic extraction, 3mm root-end resection, retrograde cavity preparation, and sealing with intermediate restorative material (IRM), followed by replantation and stabilization with flexible splints or sutures. Extraoral working time was maintained under 10 minutes to preserve periodontal ligament vitality.

Follow-up periods ranged from six months to two years. All replanted teeth remained functional, asymptomatic, and radiographically stable, showing progressive or complete resolution of periapical radiolucencies. No adverse events such as ankylosis, replacement resorption, or persistent infection were observed. The favourable outcomes are attributed to careful case selection, minimal extraoral manipulation, and the use of IRM as a reliable retrograde filling material.

This series emphasizes intentional replantation as a minimally invasive, cost-effective, and biologically sound alternative to extraction or endodontic microsurgery for the preservation of natural dentition in challenging cases.