• Muhammad Qasim Javed Assistant Professor, Department of Conservative Dental Sciences and Endodontics, Qassim University, Saudi Arabia
  • Hira Zaman
  • Swati Srivastava
  • zohra Jabeen khan



Endodontic Surgery, Fractured Instrument, Intentional Replantation


Backgrounds: Intentional replantation (IR) is a reliable and predictable treatment option for cases with failed non-surgical root canal treatment. The success of IR is found to be 52–95%. The current case is of 35years old female who presented with severe pain and swelling in lower right first mandibular molar with previously initiated non-surgical root canal treatment that resulted in instrument separation in mesio-buccal canal. Periapical radiograph showed rarefactions at furcation area, mesial and distal root apices. It was decided to complete the non-surgical root canal treatment followed by intentional replantation and retrograde filling with MTA. The tooth was found to be asymptomatic after two years follow up and periapical radiographs depicted complete healing. Intentional replantation with careful case selection is a successful, easy and reliable treatment option for hopeless cases. Atraumatic extraction, minimum extra-alveolar time and aseptic techniques during the procedure are the key factors for success of the procedure.


Torabinejad M, Dinsbach NA, Turman M, Handysides R, Bahjri K, White SN. Survival of Intentionally Replanted Teeth and Implant-supported Single Crowns: A Systematic Review. J Endod 2015;41(7):992–8.

Plotino G, Abella Sans F, Duggal MS, Grande NM, Krastl G, Nagendrababu V, et al. European Society of Endodontology position statement: Surgical extrusion, intentional replantation and tooth autotransplantation. Int Endod J 2020;53(5):1636–52.

Grossman LI. Intentional replantation of teeth. J Am Dent Assoc 1966;72(5):1111–8.

Andreasen JO, Borum MK, Jacobsen HL, Adreasen FM. Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. Endod Dent Traumatol 1995;11(2):76–89.

Weinberger BW. An introduction to the history of dentistry:Mosby; 1948.

Nizam N,Kaval M, Gürlek Ö, Atila A, Çalìşkan M. Intentional replantation of adhesively reattached vertically fractured maxillary single rooted teeth. Int Endod J 2016;49(3):227–36.

Benenati FW. Intentional replantation of a mandibular second molar with long-term follow-up: report of a case. Dent Traumatol 2003;19(4):233–6.

Trope M. Clinical management of the avulsed tooth: present strategies and future directions. Dent Traumatol 2002;18(1):1–11.

Ulfat H, Javed MQ, Haq S. Delayed replantation of avulsed tooth with 22 hours dry time: Four years follow-up of a viable treatment modality. J Ayub Med Coll Abbottabad 2021;33(2):341–3.

Jang Y, Lee SJ, Yoon TC, Roh BD, Kim E. Survival rate of teeth with a C-shaped canal after intentional replantation: a study of 41 cases for up to 11 years. J Endod2016;42(9):1320–5.

Lee W, Stover S, Rasoulianboroujeni M, Sherman K, Fahimipour F, Dashtimoghadam E, et al.The efficacy of commercial tooth storage media for maintaining the viability of human periodontal ligament fibroblasts. Int Endod J 2018;51(1):58–68.

Becker BD. Intentional replantation techniques: a critical review. J Endod 2018;44(1):14–21.

Asgary S, Alim Marvasti L, Kolahdouzan A. Indications and case series of intentional replantation of teeth. Iran Endod J2014;9(1):71–8.

Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C,et al.International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol2020;36(4):331–42.

Kahler B, Hu JY, Marriot-Smith CS, Heithersay GS. Splinting of teeth following trauma: a review and a new splinting recommendation. Aust Dent J 2016;61(1):59–73.