Intentional Replantation For Treating Type Iii Palatogingival Groove

Palatogingival groove is a developmental anomaly frequently observed in maxillary lateral incisors, which can result in severe endo-periodontal lesions, particularly Type III. This case report outlines the treatment of bilateral maxillary lateral incisors with Type III palatogingival grooves using root canal therapy (RCT) combined with intentional replantation, along with a 1-year follow-up to assess short-term efficacy. The patient presented with occlusal discomfort in the bilateral maxillary incisors, a sinus tract, and deep, narrow periodontal pockets on the palatal aspect. Radiographic examination revealed that the groove of tooth 12 communicated with the root canal, extending to the apex, while tooth 22 exhibited root canal bifurcation at the middle third, continuing to the apex as a distal root. Both teeth demonstrated periapical radiolucency and palatal alveolar bone resorption reaching the apical third. Following two weeks of RCT to control intracanal infection, intentional replantation was performed, involving apicoectomy, segmented filling of the groove, replantation, and splinting. At the 1-month follow-up, the sinus tract had completely healed, and tooth mobility had significantly improved. Initial palatal probing depths of 8mm and 12mm returned to normal. Follow-ups at 3, 6, and 12 months showed no discomfort, with radiographic evidence of new bone formation, periodontal ligament regeneration, and re-established periodontal attachment. This case demonstrates that RCT combined with intentional replantation can effectively treat Type III palatogingival grooves. When conventional palatal approaches for apical surgery are technically challenging, intentional replantation serves as a viable alternative for tooth preservation.