Intentional Re-plantation

Intentional replantation is the purposeful extraction of a tooth in order to repair a defect or cause of treatment failure and thereafter the return of the tooth to its original socket. Any tooth that can be automatically removed in one piece is ideal for intentional replantation. It becomes inevitable when:

  • Alternative endodontic non-surgical and surgical treatments have failed or are deemed impossible to perform.

  • The performance of non-surgical or surgical endodontic procedures is hampered due to limited mouth opening

  • Root-canal obstructions; and

  • Root defects caused due to either restoration or perforation that exist in areas that are not accessible via the usual surgical approach without excessive loss of root length

In order for a tooth that is to be replanted intentionally, the tooth must be kept out of the socket for the shortest period possible, and the extraction of the tooth should be done without causing any distress so as to minimize the damage to the ligaments present in the vicinity. After replantation, the tooth is splinted for ten days.

There are many reasons for an adverse outcome of a replantation viz. the tooth can fracture during extraction and may be completely lost; peri-cemental tissues can be damaged, reducing the likelihood of reattachment; infection; external root resorption etc. Therefore, it is extremely important to understand that intentional replantation should be the last choice, selected only when all the other options of treatments whether non-surgical and surgical have been exhausted. Replantation can be a treatment of choice in cases in which a surgical approach can be difficult.