Intentional replantation for the management of external root resorption: A case report with clinical insights

Abstract External root resorption is a progressive and destructive condition often triggered by trauma, which may compromise the long-term prognosis of affected teeth. This case report describes the management of a 27-year-old female who presented with pain and mobility in the maxillary anterior region, 6 months after trauma. A provisional diagnosis of symptomatic apical periodontitis secondary to chronic irreversible pulpitis was made. Clinical and radiographic assessment, supplemented with cone-beam computed tomography (CBCT), confirmed external inflammatory root resorption involving the left maxillary central and lateral incisors with associated symptomatic apical periodontitis secondary to pulp necrosis. Conventional endodontic treatment was initiated using intracanal medicaments, including calcium hydroxide and triple antibiotic paste, followed by obturation with a bioceramic sealer. Owing to the extent of resorptive defects, intentional replantation was performed. Both teeth were atraumatically extracted, extraoral defects were repaired with bioceramic putty, and the teeth were reimplanted and stabilized with a flexible splint. At the 18-month follow-up, the patient remained asymptomatic with normal probing depths, absence of mobility, and radiographs demonstrating satisfactory periapical healing without signs of progressive resorption. The patient expressed satisfaction with the treatment as it allowed preservation of her natural teeth. This case emphasizes the importance of early diagnosis with CBCT and highlights intentional replantation, combined with bioactive materials, as a viable option for advanced resorption cases that might otherwise require extraction.