A Case Of Intentional Replantation Of The Mandibular First Molar

A patient experienced swelling and pain in her lower right first molar for six months. Due to the great apical surgery difficulty, intentional replantation was chosen and achieved good results six months later. A female patient presented with swelling and pain in her lower right first molar for six months. The tooth had undergone root canal treatment and crown restoration one year previously. Intraoral examination revealed a full crown restoration, slightly red and swollen buccal gingiva, grade II mobility, percussion pain, and an average periodontal attachment loss of 1 mm. CBCT showed extensive bone destruction in the periapical and furcation regions. After obtaining informed consent, intentional replantation was performed. The tooth was extracted, the root apex was sectioned off in stages, root canal preparation and retrograde filling were done, and the tooth was replanted and stabilized. At the six-month follow-up, periapical bone had healed. Intentional replantation is usually for single-rooted teeth, with over 80% success rate when properly indicated. For mandibular first molars with multiple roots and large root bifurcations, microsurgical apical surgery is typically next after non-surgical root canal retreatment fails. However, in this case, due to the intact and thick buccal bone wall of the molar, large buccolingual root diameter, and significant root bifurcation bone destruction, intentional replantation was attempted. This approach allowed extraoral operation and minimal apical resection. Given the tooth's acceptable periodontal condition, good results were achieved. Intentional replantation is a viable alternative for preserving multi - rooted molars.