Twenty-year follow-up of an unconventional intentional replantation

For many years, intentional replantation has been a treatment option for pulpless teeth and an effective strategy for teeth that would be difficult, if not impossible, to treat using traditional root canal therapy. The preservation of cell vitality in the periodontal ligament, the removal of all tissue debris and irritating substances from the root surface, achievement of a good apical seal and reinforcement of the crown structure are critical in ensuring normal function of the reimplanted tooth. In this article, we report on an unconventional intentional replantation of a mandibular second molar to relieve continuing symptoms. Retrograde fillings were placed in the second molar and the coronal pulp chamber was sealed with amalgam. No endodontic therapy was carried out either during or after the procedure. After 20 years, the patient was asymptomatic, the tooth was still functional and a recall intraoral periapical radiograph showed an intact periodontal ligament space and lamina dura with no evidence of gross root resorption or ankylosis.