Intentional Replantation To Treat Periapical Lesion And Subgingival Cervical Caries

This case report describes the 3-year outcome of intentional replantation to save a mandibular second molar with cervical caries, unfilled lateral canal and periapical inflammation. It shows the significance of intentional replantation, which can serve as an effective method for preserving the affected tooth when no other viable options are available. A 68-year-old female patient reported pain in tooth 37 following prior root canal treatment and restoration. Clinical evaluation revealed distal cervical caries, moderate percussion tenderness, and a deep periodontal pocket. Radiographic analysis indicated periapical radiolucency surrounding the mesial root (Fig.1). The surgical intervention comprised extraction of the tooth, apical root resection, retrograde filling, cavity filling, and subsequent replantation (Fig.2). After a follow-up period of 3 years, the tooth exhibited normal function without evidence of root resorption or ankylosis (Fig.3). Posttreatment endodontic disease is a significant issue for endodontic specialists [1,2]. Effective infection control and identification of the root canal morphology are paramount for successful endodontic treatment [3,4]. In our case, intentional replantation was chosen to make the treatment procedure much more operable and minimally invasive, as the lateral canal and distal cervical caries could be clearly observed under the microscope, and all of the treatment steps could be accomplished quickly and precisely. The successful outcome in this case supports the idea of performing intentional replantation to save teeth with posttreatment periapical lesions and severe subgingival cervical caries.