{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:47:29Z","timestamp":1782395249003,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Intentional replantation (IR) is a conservative treatment option for compromised teeth when the viability of the periodontal ligament (PDL) can be preserved. Maintaining viable PDL cells and using bioactive agents such as ethylenediaminetetraacetic acid (EDTA), platelet\u2010rich fibrin (PRF), and injectable platelet\u2010rich fibrin (i\u2010PRF) may enhance the regenerative potential of replanted teeth.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A 59\u2010year\u2010old female patient presented with Grade III mobility and extrusion of maxillary tooth #9 following trauma. Clinical examination revealed a probing depth of 10\u00a0mm with bleeding on probing. After initial periodontal therapy and root canal treatment, the tooth was atraumatically extracted for IR. The extraoral time was limited to 10 min. Root surface instrumentation and 24% EDTA conditioning were performed only on the cervical and middle thirds of the root, while the apical PDL region was preserved without decalcification or curettage to maintain cell viability. i\u2010PRF and PRF were prepared from the patient's venous blood. i\u2010PRF was applied into the socket to enhance biological activity, and PRF was placed on the buccal aspect to support soft\u2010tissue healing. After replantation, the tooth was stabilized with a rigid splint.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Postoperative pain measured on the visual analog scale was 6 on day 1, 2 on day 3, and 0 on day 7. The initial 10\u00a0mm probing depth decreased to 4\u00a0mm at 1 month and 3\u00a0mm at 3 months, remaining stable throughout the 1\u2010year follow\u2010up. Radiographically, no ankylosis or root resorption was detected. The gingival index decreased from 2 to 0, and the periodontal tissues remained healthy and stable.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This case demonstrates that IR performed with atraumatic extraction, a short extraoral period, and preservation of the apical PDL without decalcification can successfully retain a tooth with advanced mobility. The synergistic use of EDTA, PRF, and i\u2010PRF created a favorable microenvironment for periodontal healing. This biologically oriented protocol represents one of the rare regenerative IR cases in which success was achieved without apical PDL decalcification.<\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n Preservation of viable periodontal ligament tissue is critical for successful intentional replantation.<\/jats:p>\n <\/jats:list-item>\n \n Limited apical socket preparation may facilitate passive reinsertion while minimizing compression of the apical periodontal ligament.<\/jats:p>\n <\/jats:list-item>\n \n Intentional replantation may be considered as a tooth\u2010preserving treatment option in selected cases with trauma\u2010related periodontal damage.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Plain Language Summary<\/jats:title>\n Saving teeth with severe damage is often difficult, especially when there is both gum tissue destruction and a history of dental trauma. In this case report, a severely mobile upper front tooth was treated using intentional replantation, a procedure in which the tooth is carefully removed and then placed back into its socket after treatment. During the procedure, special attention was given to preserving the living tissues attached to the root surface, since these tissues are important for healing. Additional regenerative materials derived from the patient's blood were also used to support recovery. Clinical and radiographic follow\u2010up examinations showed reduced tooth mobility, decreased periodontal pocket depth, and satisfactory healing without signs of root resorption or fusion of the tooth to the bone. This case suggests that intentional replantation may help preserve selected teeth that would otherwise be considered for extraction when careful surgical techniques and appropriate biological support are used.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cap.70084","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:57:42Z","timestamp":1782392262000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intentional replantation with apical periodontal ligament preservation: A case report"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8687-8660","authenticated-orcid":false,"given":"Nuri","family":"Ger\u00e7ek","sequence":"first","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry Hacettepe University Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3255-7943","authenticated-orcid":false,"given":"Dilara Gizem","family":"K\u0131l\u0131\u00e7kaya","sequence":"additional","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry Hacettepe University Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0699-2825","authenticated-orcid":false,"given":"Zeynep Buket","family":"Da\u011f","sequence":"additional","affiliation":[{"name":"Department of Endodontics Faculty of Dentistry Hacettepe University Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3689-9789","authenticated-orcid":false,"given":"Abdullah Cevdet","family":"Akman","sequence":"additional","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry Hacettepe University Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"issue":"1","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1034\/j.1600-9657.2003.00084.x","article-title":"Intentional replantation for periodontally involved hopeless teeth","volume":"19","author":"Demiralp B","year":"2003","journal-title":"Dent Traumatol"},{"issue":"1","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5051\/jpis.2014.44.1.13","article-title":"Delayed intentional replantation of periodontally hopeless teeth: a retrospective study","volume":"44","author":"Lee E\u2010U","year":"2014","journal-title":"J Periodontal Implant Sci"},{"issue":"1","key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.joen.2017.08.002","article-title":"Intentional replantation techniques: a critical review","volume":"44","author":"Becker BD","year":"2018","journal-title":"J Endod"},{"issue":"3","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1111\/j.1600-9657.2005.00414.x","article-title":"Intentional replantation of a hopeless tooth with the combination of platelet rich plasma, bioactive glass graft material and non\u2010resorbable membrane: a case report","volume":"23","author":"Demir B","year":"2007","journal-title":"Dent Traumatol"},{"issue":"3","key":"e_1_2_8_6_1","first-page":"152","article-title":"Intentional replantation: no longer a last resort for saving a natural tooth","volume":"45","author":"Lee SM","year":"2024","journal-title":"Compend Contin Educ Dent"},{"issue":"1","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1038\/s41368-024-00337-5","article-title":"Expert consensus on intentional tooth replantation","volume":"17","author":"Lin Z","year":"2025","journal-title":"Int J Oral Sci"},{"issue":"3","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/S0011-8532(22)00071-4","article-title":"Intentional replantation","volume":"41","author":"Kratchman S","year":"1997","journal-title":"Dent Clin North Am"},{"issue":"2","key":"e_1_2_8_9_1","first-page":"325","article-title":"Intentional replantation. A viable alternative for selected cases","volume":"38","author":"Dryden JA","year":"1994","journal-title":"Dent Clin North Am"},{"issue":"4","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/sj.bdj.4808392","article-title":"Replantation in general dental practice","volume":"176","author":"Sharma NK","year":"1994","journal-title":"Br Dent J"},{"issue":"3","key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.4103\/0972-0707.85789","article-title":"Strategies for periodontal ligament cell viability: an overview","volume":"14","author":"Goswami M","year":"2011","journal-title":"J Conserv Dent"},{"issue":"17","key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"6249","DOI":"10.3390\/jcm14176249","article-title":"Tooth autotransplantation in contemporary dentistry: a narrative review of its clinical applications and biological basis","volume":"14","author":"Meto A","year":"2025","journal-title":"J Clin Med"},{"issue":"4","key":"e_1_2_8_13_1","article-title":"A comparative evaluation of the periodontal ligament cell viability using placentrex, propolis, and Hanks' Balanced Salt Solution: an in\u2010vitro study","volume":"16","author":"Shankar Havaldar K","year":"2024","journal-title":"Cureus"},{"issue":"1","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1038\/s41598-020-59843-1","article-title":"Survival and complication analyses of avulsed and replanted permanent teeth","volume":"10","author":"M\u00fcller DD","year":"2020","journal-title":"Sci Rep"},{"issue":"15","key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1089\/scd.2019.0031","article-title":"Periodontal ligament stem cells: regenerative potency in periodontium","volume":"28","author":"Tomokiyo A","year":"2019","journal-title":"Stem Cells Dev"},{"issue":"4","key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1634\/stemcells.2007-0734","article-title":"Periodontal ligament stem cell\u2010mediated treatment for periodontitis in miniature swine","volume":"26","author":"Liu Y","year":"2008","journal-title":"Stem Cells"},{"issue":"3","key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1002\/jcp.21710","article-title":"Immunomodulatory properties of human periodontal ligament stem cells","volume":"219","author":"Wada N","year":"2009","journal-title":"J Cell Physiol"},{"issue":"1","key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1002\/jcp.25067","article-title":"Potential for stem cell\u2010based periodontal therapy","volume":"231","author":"Bassir SH","year":"2016","journal-title":"J Cell Physiol"},{"issue":"9429","key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0140-6736(04)16627-0","article-title":"Investigation of multipotent postnatal stem cells from human periodontal ligament","volume":"364","author":"Seo B\u2010M","year":"2004","journal-title":"Lancet"},{"key":"e_1_2_8_20_1","article-title":"Periodontal ligament stem cells: current status, concerns, and future prospects","volume":"2015","author":"Zhu W","year":"2015","journal-title":"Stem Cells Int"},{"issue":"1","key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.34172\/joddd.2022.002","article-title":"Attachment of human periodontal ligament fibroblasts to root dentin conditioned with different endodontic irrigants: an experimental study","volume":"16","author":"Khoshbin E","year":"2022","journal-title":"J Dent Res Dent Clin Dent Prospects"},{"issue":"12","key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"5479","DOI":"10.3390\/ijms26125479","article-title":"Platelet\u2010rich plasma and platelet\u2010rich fibrin in endodontics: a scoping review","volume":"26","author":"Rebimbas Guerreiro S","year":"2025","journal-title":"Int J Mol Sci"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.70017"},{"issue":"1","key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/edt.12982","article-title":"Assessment of the effects of citric acid and EDTA on cell viability of cultured human periodontal ligament cells attached to simulated avulsed permanent tooth using a spectrofluorometer\u2010an in vitro study","volume":"41","author":"Doiphode AR","year":"2025","journal-title":"Dent Traumatol"},{"issue":"6","key":"e_1_2_8_25_1","first-page":"606","article-title":"[Effect of EDTA and hyaluronic acid on the activity of periodontal ligament fibroblasts and the expression of cytokines]","volume":"29","author":"Zheng J","year":"2020","journal-title":"Shanghai Kou Qiang Yi Xue"},{"issue":"3","key":"e_1_2_8_26_1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/aej.12492","article-title":"The impact of platelet\u2010rich fibrin (PRF) on delayed tooth replantation: a preliminary animal study","volume":"47","author":"Behnaz M","year":"2021","journal-title":"Aust Endod J"},{"issue":"8","key":"e_1_2_8_27_1","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1007\/s00784-017-2063-9","article-title":"Injectable platelet rich fibrin (i\u2010PRF): opportunities in regenerative dentistry?","volume":"21","author":"Miron RJ","year":"2017","journal-title":"Clin Oral Investig"},{"issue":"8","key":"e_1_2_8_28_1","article-title":"Injectable platelet\u2010rich fibrin\u2014a revolution in periodontal regeneration","volume":"14","author":"Gollapudi M","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_8_29_1","unstructured":"MillerSC.Textbook of Periodontia: Oral Medicine.1943."},{"issue":"1","key":"e_1_2_8_30_1","first-page":"S173","article-title":"Periodontitis: Consensus Report of Workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri\u2010Implant Diseases and Conditions","volume":"89","author":"Papapanou PN","year":"2018","journal-title":"J Periodontol"},{"issue":"6","key":"e_1_2_8_31_1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/j.1600-051X.1992.tb00666.x","article-title":"A randomized trial of occlusal adjustment in the treatment of periodontitis patients","volume":"19","author":"Burgett FG","year":"1992","journal-title":"J Clin Periodontol"},{"key":"e_1_2_8_32_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1600-0757.2005.00141.x","article-title":"Structure of periodontal tissues in health and disease","volume":"40","author":"Nanci A","year":"2006","journal-title":"Periodontol 2000"},{"issue":"3","key":"e_1_2_8_33_1","first-page":"244","article-title":"Replantation after dental avulsion: a scoping review and proposal of a flow chart","volume":"25","author":"Zerman N","year":"2024","journal-title":"Eur J Paediatr Dent"},{"issue":"3","key":"e_1_2_8_34_1","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1600-9657.2008.00555.x","article-title":"Treatment of root surface in delayed tooth replantation: a review of literature","volume":"24","author":"Panzarini SR","year":"2008","journal-title":"Dent Traumatol"}],"container-title":["Clinical Advances in Periodontics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cap.70084","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cap.70084","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cap.70084","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:57:53Z","timestamp":1782392273000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1002\/cap.70084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":33,"alternative-id":["10.1002\/cap.70084"],"URL":"https:\/\/doi.org\/10.1002\/cap.70084","archive":["Portico"],"relation":{},"ISSN":["2573-8046","2163-0097"],"issn-type":[{"value":"2573-8046","type":"print"},{"value":"2163-0097","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"2026-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cap.70084"}}