Intentional replantation as an alternative treatment: survival analysis and key prognostic indicators

This retrospective cohort study aimed to evaluate the survival outcomes of intentional replantation (IR), an alternative endodontic treatment option when conventional and surgical approaches are not feasible, and to identify key prognostic indicators influencing tooth survival. A total of 55 teeth from 47 patients (36 females, 19 males) treated with IR were retrospectively analyzed. Clinical and radiographic data were collected over a mean follow-up period of 25.9 ± 18.7 months. Kaplan–Meier survival analysis with Log-rank tests, Fisher’s Exact test, and Cox regression were used to assess survival time, categorical associations, and independent prognostic factors including gender, percussion and palpation sensitivity, periapical lesion status, and splint type. The overall survival rate was 87.3% (48/55 teeth). The presence of preoperative periapical lesions significantly reduced survival (p = 0.001), while teeth stabilized with fiber-reinforced splints exhibited significantly better outcomes than those with rigid wire-composite splints (p = 0.003). Both factors remained independently associated with survival in Cox regression analysis. IR may represent a viable alternative option in selected cases, with splint type and preoperative periapical lesions emerging as factors associated with survival; however, findings should be interpreted considering the retrospective design and limited number of failure events.