The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 12 , ISSUE 6 ( November-December, 2011 ) > List of Articles


Intentional Replantation: A Procedure as a Last Resort

Hamid Jafarzadeh, Armita Rouhani, Babak Javidi, Morteza Habibi

Citation Information : Jafarzadeh H, Rouhani A, Javidi B, Habibi M. Intentional Replantation: A Procedure as a Last Resort. J Contemp Dent Pract 2011; 12 (6):486-492.

DOI: 10.5005/jp-journals-10024-1081

Published Online: 01-12-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.



To address the indications, contraindications, surgical procedure, complications following treatment, factors influencing the results and success rate of intentional replantation procedure.


Intentional replantation is extraction of a tooth to do extraoral root canal therapy, curettage of apical lesion when present, and its replacement in its socket. It has been proposed as an alternative to routine extraction; however, it should be considered a last resort because the root may be fractured during extraction.


The success rate of intentional replantation is far below than routine endodontic treatment or apical surgery. Difficultness of tooth extraction, the possibility of fracture during extraction and the risk of external resorption are some limitations of this treatment. The most common causes of failure in intentionally replanted teeth are external inflammatory resorption or replacement resorption and ankylosis caused by periodontal ligament damage.


The success rate up to 95% with an average retention of 3 to 5 years, has been reported.

Clinical significance

In some cases, endodontic retreatment or apical surgery is impossible or impractical. In these situations, intentional replantation may be considered as a last resort for preserving the tooth, so all clinicians should know about its indications/contraindications, surgical procedure and complications following treatment.

How to cite this article

Rouhani A, Javidi B, Habibi M, Jafarzadeh H. Intentional Replantation: A Procedure as a Last Resort. J Contemp Dent Pract 2011;12(6):486-492.

PDF Share
  1. Intentional replantation of teeth. J Am Dent Assoc 1966;72:1111-18.
  2. Intentional replantation of a lower premolar. Aust Endod J 2004;30:99-102.
  3. Intentional replantation of teeth: A clinical evaluation. J Am Dent Assoc 1982;104:633-39.
  4. Endodontic Practice (11th ed). Philadelphia: Lea and Febiger, 1988.
  5. Intentional surgical repositioning of an ankylosed permanent maxillary incisor. Dent Traumatol 2002;18(4):222-26.
  6. Introduction to the History of Dentistry. St Louis: Mosby, 1948.
  7. Le Chirurgien dentist outrait edes'dents. Paris: Chez Pierre-Jean Mariette 1746.
  8. A treatise on the disorders and deformities of the teeth and gums. London: White, Dodsley, Beckett and deHondt 1768.
  9. Practical observations on the teeth. London: J Johnson 1783.
  10. A practical treatise on the diseases of the teeth. London. J Johnson 1778.
  11. Die replantation der zahne. Ost Vjschr Zahnheilkd 1890;2:181-278.
  12. Replantation and implantation of teeth. Int Dent J 1955;5:439-57.
  13. Experimental replantation of teeth in dogs and monkeys. Arch Oral Biol 1961;3:176-84.
  14. Reimplantation of luxated teeth in humans. J South Calif Dent Assoc 1965;33:194-206.
  15. Treatment of pulpal and periapical disease by replantation. Br Dent J 1966;121(4):159-66.
  16. Intentional replantation of teeth in dogs and monkeys. J Dent Res 1968;47(6):1066-71.
  17. Intentional replantation. Dent Clin North Am 1997;41:603-17.
  18. Intentional replantation: A ‘last resort’ treatment or a conventional treatment procedure? nine case reports. Dent Traumatol 2004;20(1):48-55.
  19. Endodontic Therapy (4th ed). St Louis: Mosby 1989.
  20. Intentional replantation. Aust Endod J 1998;24: 78-80.
  21. Intentional replantation. A viable alternative for selected cases. Dent Clin North Am 1994;38: 325-53.
  22. Intentional replantation: A successful alternative for hopeless teeth. Oral Surg Oral Med Oral Pathol 1991;71: 743-47.
  23. Intentional replantation: A case report. J Endod 1980;6(6):610-13.
  24. Intentional replantation for the management of maxillary sinusitis. Int Endod J 2007;40(11):891-99.
  25. The case against intentional replantation. J Am Dent Assoc 1980;100:664-68.
  26. Survival rate of replanted teeth. Oral Surg Oral Med Oral Pathol 1970;29(6):899-906.
  27. Intentional replantation of a maxillary molar. A 4 years follow-up. Oral Surg Oral Med Oral Pathol 1982;54(6):686-88.
  28. Intentional replantation to prevent predictable endodontic failures. Oral Surg Oral Med Oral Pathol 1984;57:423-32.
  29. Clinical evaluation of gold foil as an apical sealing material for replantation. Oral Surg Oral Med Oral Pathol 1983;55:514-18.
  30. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(4):e85-87.
  31. International reimplantation of teeth; report of two cases. Oral Surg Oral Med Oral Pathol 1964;18:681-85.
  32. Intentional replantation for iatrogenic perforation of the furcation: A case report. Quintessence Int 1996;27(10):691-96.
  33. Intentional replantation of endodontically treated teeth. Oral Surg Oral Med Oral Pathol 1993;76:623-30.
  34. Intentional replantation: Report of a successful case. Quintessence Int 1992;23(11): 755-57.
  35. Repair of a root perforation with a resin-ionomer using an intentional replantation technique. Gen Dent 1999;47(4):392-95.
  36. Intentional replantation for periodontally involved hopeless teeth. Dent Traumatol 2003;19(1):45-51.
  37. Periodontal healing after intentional autoalloplastic reimplantation of injured immature upper front teeth. J Clin Periodontol 2000;27(3): 198-204.
  38. Vertical root fracture treated by bonding fragments and rotational replantation. Dent Traumatol 2002;18(1):42-45.
  39. Prognosis of intentional replantation of vertically fractured roots reconstructed with dentin-bonded resin. J Endod 2004;30:145-48.
  40. Replantation with intentional rotation of a complete vertically fractured root using adhesive resin cement. Dent Traumatol 2003;19(2):115-17.
  41. Short-term evaluation of intentional replantation of vertically fractured roots reconstructed with dentin-bonded resin. J Endod 2002;28(2):120-24.
  42. Repair of incomplete vertical root fractures in endodontically treated teeth—in vivo trials. J Endod 1996;22(8):426-29.
  43. Management of a complicated crown-root fracture in a young permanent incisor using intentional replantation. Dent Traumatol 2008;24(1): 100-03.
  44. Successful treatment of a radicular groove by intentional replantation and Emdogain therapy. Dent Traumatol 2004;20(4):226-28.
  45. Extraoral endodontic treatment, odontotomy and intentional replantation of a double maxillary lateral permanent incisor: case report and 6 years follow-up. Int Endod J 2008;41(6): 538-46.
  46. Successful treatment of a radicular groove by intentional replantation and Emdogain therapy: Four years follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e82-85.
  47. Maintenance of alveolar bone by the intentional replantation of roots. Oral Surg Oral Med Oral Pathol 1974;37(6):936-45.
  48. Treatment of combined endodonticperiodontic lesions by intentional replantation and application of hydroxyapatites. Dent Traumatol 2003;19(1):60-63.
  49. Intentional replantation of periodontally involved and endodontically mistreated tooth. Oral Surg Oral Med Oral Pathol 1986;61(5):508-13.
  50. Intentional replantation. Oral Surg Oral Med Oral Pathol 1986;62:707-09.
  51. Treatment of the avulsed permanent tooth. Recommended guidelines of the American association of endodontists. Dent Clin North Am 1995;39: 221-25.
  52. Intentional replantation of mandibular premolars and molars. J Am Dent Assoc 1971;83(5):1053-57.
  53. Treatment of replacement resorption with Emdogain: A prospective clinical study. Dent Traumatol 2002;18(3):138-43.
  54. Effect of enamel matrix derivative (EMDOGAIN) upon periodontal healing after replantation of permanent incisors in beagle dogs. Dent Traumatol 2001;17(1):36-45.
  55. Clinical management of avulsed permanent incisors using Emdogain: Initial report of an investigation. J Can Dent Assoc 2000;66(1):21.
  56. Intentional replantation of an immature permanent lower incisor because of a refractory periapical lesion: Case report and 5 years followup. Int J Paediatr Dent 2004;14(3):218-22.
  57. Intentional replantation with 180 degrees rotation of a crownroot fracture: A case report. Dent Traumatol 2003;19(6):321-25.
  58. Long-term results after intentional tooth reimplantation in monkeys. Oral Surg Oral Med Oral Pathol 1977;44(5):666-78.
  59. Relationship between cell damage in the periodontal ligament after replantation and subsequent development of root resorption. A time-related study in monkeys. Acta Odontol Scand 1981;39(1):15-25.
  60. Replantation in general dental practice. Br Dent J 1994;176(4):147-51.
  61. Replantation The role of the socket. J Endod 1980;6(3):479-84.
  62. Treatment of extrusive luxation by intentional replantation. Int J Paediatr Dent 2007;17(2):134-38.
  63. Transplantation of displaced and dilacerated anterior teeth. Endod Dent Traumatol 1998;14: 93-98.
  64. Intentional replantation of a mandibular second molar with long-term follow-up: Report of a case. Dent Traumatol 2003;19(4):233-36.
  65. Retrograde root filling with composite and a dentin-bonding agent. 1. Endod Dent Traumatol 1991;7(3):118-25.
  66. Long-term evaluation of retrograde root filling with dentin-bonded resin composite. J Endod 1996;22(2):90-93.
  67. Vitality of human lip fibroblasts in milk, Hanks balanced salt solution and Viaspan storage media. Endod Dent Traumatol 1991;7(2):69-72.
  68. Intentional replantation of endodontically treated teeth: An update. Compend Contin Educ Dent 2003;24:68-72,74.
  69. Replantation of teeth. II. Histological study of 22 replanted anterior teeth in humans. Acta Odontol Scand 1966;24:287-306.
  70. Surgical Endodontics. Boston: Blackwell Scientific, 1991.
  71. Intentional replantation of a hopeless tooth with the combination of platelet rich plasma, bioactive glass graft material and nonresorbable membrane: A case report. Dent Traumatol 2007;23:190-94.
  72. Periodontal reattachment after tooth replantation. Periodontics 1968;6(4):161-67.
  73. Intentional replantation for a periodontally involved hopeless incisor by using autologous platelet-rich plasma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:e119-24.
  74. Intentional replantation: A report of 192 cases. Gen Dent 1988;36:327-31.
  75. Factors affecting healing after experimentally delayed tooth transplantation. J Endod 1981;7(2):80-84.
  76. Splinting and replantation after traumatic avulsion. J Am Dent Assoc 1986;112(2):224-30.
  77. Epithelial rests’ function in replantation: Is splinting necessary in replantation? Oral Surg Oral Med Oral Pathol 1990;70(5):644-49.
  78. Tooth replantation. Dent Clin North Am 1974;18(2):445-52.
  79. Treatment of root perforation by intentional reimplantation: A case report. Endod Dent Traumatol 1999;15:132-34.
  80. Acrylic splint for intentional replantation. Oral Surg Oral Med Oral Pathol 1970;30:537-39.
  81. Treatment of intrabony periodontal defects with an enamel matrix protein derivative (Emdogain): A report of 32 cases. Int J Periodontics Restorative Dent 1999;19:157-63.
  82. Application of enamel matrix derivative for tooth transplantation and replantation. Kokubyo Gakkai Zasshi 2000;67(2):133-45.
  83. Treatment of replacement resorption by intentional replantation, resection of the ankylosed sites, and Emdogain: Results of a 6 years survey. Dent Traumatol 2006;22(6):307-11.
  84. Replantation of extracted molars; preliminary report. Oral Surg Oral Med Oral Pathol 1956;9(1):115-22.
  85. Replantation of teeth. I. Radiographic and clinical study of 110 human teeth replanted after accidental loss. Acta Odontol Scand 1966;24(3):263-86.
  86. Dentoalveolar ankylosis and associated root resorption in replanted teeth. Experimental and clinical studies in monkeys and man. Swed Dent J Suppl 1988;56:1-75.
  87. Intentional replantation: A case report and review of the literature. JNJ Dent Assoc 1995;66:63-65.
  88. Replantation: A clinical philosophy. J Am Dent Assoc 1980;101(1):17-19.
  89. Re-inventing intentional replantation: A modification of the technique. Pract Proced Aesthet Dent 2001;13(6):433-39.
  90. A time-related study of periodontal healing and root resorption activity after replantation of mature permanent incisors in monkeys. Swed Dent J 1980;4:101-10.
  91. The effect of limited drying or removal of the periodontal ligament. Periodontal healing after replantation of mature permanent incisors in monkeys. Acta Odontol Scand 1981;39:1-13.
  92. Relationship between surface and inflammatory resorption and changes in the pulp after replantation of permanent incisors in monkeys. J Endod 1981;7:294-301.
  93. Replantation of teeth. Dent Items Interest 1935;57:675-92.
  94. Experimental replantation of root-canal-filled and untreated teeth in the vervet monkey. J Endod 1977;3(3):89-93.
  95. Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. Endod Dent Traumatol 1995;11(2):76-89.
  96. Variations in the presenting and treatment features in reimplanted permanent incisors in children and their effect on the prevalence of root resorption. Br Dent J 2000;189(5):263-66.
  97. Treatment of fractured and avulsed teeth. ASDC J Dent Child 1971;38(1):29-31.
  98. A clinical investigation of root resorption rates in reimplanted young permanent incisors: A five-year study. J Endod 1980;6(1):413-20.
  99. It's a knock-out—an avulsed tooth campaign. J Endod 1980;6: cover 2, 425-27.
  100. The effect of root canal therapy on replanted teeth of dogs; a gross, roentgenographic, and histologic study. Oral Surg Oral Med Oral Pathol 1964;18:227-42.
  101. Results of intentional replantation of molars. J Oral Maxillofac Surg 1999;57(3):240-44.
  102. Replantation of extracted molars. A radiographic and histological study. Acta Odontol Scand 1966;24:327-46.
  103. Emergency treatment of dislodged incisors using soft alloys splints. Dent Pract 1958;9:74-77.
  104. Retrograde amalgam filling: A scanning electron microscopic study. J Endod 1975;1(1):28-31.
  105. Methods and criteria in evaluation of periapical tissue response. Int Dent J 1970;20(3):533-38.
  106. Sealing quality of polycarboxylate cements when compared to amalgam as retrofilling material. Oral Surg Oral Med Oral Pathol 1976;42:109-16.
  107. A comparative sealability study of different retrofilling materials. Oral Surg Oral Med Oral Pathol 1978;45:273-81.
  108. Successful intentional reimplantation of mandibular molars. Quintessence Int 1988;19(8):585-88.
  109. Twenty-year follow-up of an unconventional intentional replantation. J Can Dent Assoc 2006;72(7):639-42.
  110. Outcome of tooth transplantation: Survival and success rates 17-41 years posttreatment. Am J Orthod Dentofac Orthop 2002;121(2):110-19.
  111. Clinical evaluation and histologic study of intentionally replanted teeth. Transactions of the fourth international conference on endodontics. Philadelphia, University of Pennsylvania 1968.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.