Intentional Replantation - The last resort or a vital treatment alternative?

Objectives: Intentional Replantation (IR) is a procedure of elective extraction and insertion a tooth into its alveolus, for the purpose of performing treatment such as root end filling or correction of perforations. The aim of this study is to present the technique and examine its relevancy as an alternative treatment approach.
Methods: PubMed literature search was performed to retrieve the variety of clinical treatment modalities addressing IR. Resulted literature was evaluated to assess the relevancy of the technique and its success rate.
Three years follow up outcome will be presented of successful and failed cases.
Results: According to literature search IR should be considered as a last resort mainly because of root fracture during extraction. The success rate of IR is far below routine root canal treatment or apical surgery. The most common cause of failure is periodontal ligament damage resulted in inflammatory resorption or replacement resorption and ankylosis. Using the Kratchman technique (1977) for IR, with a maintain viability of the periodontal ligament, the IR maybe a relevant treatment option. The case presented demonstrate 3 years of follow-up with complete periapical healing.
Conclusions: IR is considered as a last resort. It can be proposed as an alternative to tooth extraction in several specific indications. Proper clinical and radiographic examination, correct diagnosis and treatment planning are key features for successful IR. In cases where periapical surgery is impractical, an IR procedure may serve as a suitable alternative. Proper case selection and meticulous technique are crucial factor to expand the success rate of the procedure.