Application of intentional reimplantation in the treatment of severe periodontitis

Severe periodontitis is a major cause of tooth loss, and the management of hopeless teeth remains a clinical challenge. Intentional reimplantation has been proposed as a conservative alternative to extraction and prosthetic replacement, but its clinical value in periodontitis-affected teeth has not been fully established. In this study, sixty patients with severe periodontitis, each contributing a single tooth, underwent intentional reimplantation and were followed for 18 months. Clinical examinations and radiographic assessments were performed at 3, 6, 9, 12, and 18 months after surgery. At the final follow-up, 53 teeth were successfully retained, corresponding to a survival rate of 88.3%, with cumulative survival rates of 100%, 96.7%, 95.0%, and 91.7% at 3, 6, 9, and 12 months, respectively. Among the retained teeth, 45 (85.0%) developed ankylosis, and the overall improvement rate in mobility reached 83.3%. Periodontal parameters, including probing depth and adjacent bone loss, were significantly improved compared with baseline values (P < .05). These findings indicate that intentional reimplantation is an effective approach for selected teeth with severe periodontitis, allowing for preservation of natural dentition and restoration of function. Although ankylosis frequently represents the predominant healing modality, the procedure remains clinically valuable and may serve as an alternative treatment when conventional periodontal therapy is inadequate.