Preserving a hopeless tooth via intentional replantation in advanced periodontitis

Erez Palacı A. B., İnönü E.

FDI World Dental Congress, Praha, Çek Cumhuriyeti, 4 - 07 Eylül 2026, ss.1, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Praha
  • Basıldığı Ülke: Çek Cumhuriyeti
  • Sayfa Sayıları: ss.1
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Introduction 

 

Advanced periodontitis often necessitates tooth extraction due to mobility and bone loss. In the esthetic zone, intentional replantation (IR) serves as a viable alternative to radical surgery by providing a controlled environment for preserving alveolar bone and soft tissues.

 

Case Description 

 

A systemically healthy 43-year-old male was diagnosed with Stage 4 Grade C periodontitis involving tooth 31, which exhibited Class 3 mobility and a hopeless prognosis. Following Phase 1 therapy and endodontic treatment, the tooth was atraumatically extracted. Extraoral debridement was performed, followed by root surface biomodification with Tetracycline-HCl for 5 minutes. To ensure periodontal ligament viability, extraoral time was limited to under 15 minutes. Upon replantation, the tooth was placed in infra-occlusion and stabilized with a passive splint for 6 months, followed by permanent splinting. At the 12-month follow-up, significant clinical attachment gain and radiographic bone fill were recorded without complications.

 

Discussion 

 

Consistent with evidence-based protocols, maintaining extraoral time under 15 minutes is the primary determinant for preserving periodontal ligament cell viability. Tetracycline-HCl biomodification supports new attachment formation by effectively removing the smear layer and exposing collagen fibers. This case demonstrates that IR is a reliable clinical alternative when following systematic protocols. 

 

Conclusion/Clinical Significance 

 

Intentional replantation effectively maintains teeth with a hopeless prognosis in function through meticulous case selection and protocols. This approach is of paramount clinical importance as it defers implant requirements, reduces costs, and preserves existing alveolar bone.