{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T21:53:24Z","timestamp":1774734804060,"version":"3.50.1"},"reference-count":32,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Intentional replantation (IR) may offer a solution for persistent periapical lesions associated with endodontically treated teeth. A 35-year-old male patient presented with pain associated with the left mandibular second molar and hypoesthesia. Upon clinical examination, increased probing pocket depth in the mid-buccal surface was detected. Cone beam computed tomography revealed a previous non-surgical root canal treatment, with root canal filling material extrusion adjacent to the inferior alveolar nerve, a fractured instrument in the mesial root, and a large periapical radiolucency involving both teeth 37 and 36. A diagnosis of symptomatic post-treatment apical periodontitis was established. After discussing treatment options with the patient, an IR of tooth 37 was performed. Extra-oral procedures were completed in 17 min. At 9 months, hypoesthesia resolution was reported, and apical healing was radiographically observed. After 2.5 years, the replanted tooth showed extensive root resorption. An extraction with alveolar ridge preservation, using leukocyte-platelet rich fibrin (L-PRF), was performed. Six months after tooth extraction and regeneration, implant placement surgery was carried out. IR presents a valid treatment modality for the management of post-treatment apical periodontitis. When orthograde retreatment or apical microsurgery prove to be unfeasible, IR is a unique procedure with the potential to promote tooth preservation in properly selected cases. Although unsuccessful after 2.5 years, the IR of tooth 37 allowed for bone regeneration, the maintenance of tooth 36 vitality, and hypoesthesia resolution.<\/jats:p>","DOI":"10.3390\/jcm11175111","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:13:56Z","timestamp":1661904836000},"page":"5111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Intentional Replantation as a Starting Approach for a Multidisciplinary Treatment of a Mandibular Second Molar: A Case Report"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2865-9689","authenticated-orcid":false,"given":"Jo\u00e3o Miguel","family":"Santos","sequence":"first","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), 3000-548 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-6155","authenticated-orcid":false,"given":"Joana A.","family":"Marques","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Margarida","family":"Esteves","sequence":"additional","affiliation":[{"name":"Institute of Paediatric and Preventive Dentistry, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3219-1078","authenticated-orcid":false,"given":"V\u00edtor","family":"Sousa","sequence":"additional","affiliation":[{"name":"Institute of Pathological Anatomy, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4730-8072","authenticated-orcid":false,"given":"Paulo J.","family":"Palma","sequence":"additional","affiliation":[{"name":"Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2548-4326","authenticated-orcid":false,"given":"S\u00e9rgio","family":"Matos","sequence":"additional","affiliation":[{"name":"Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"},{"name":"Institute of Periodontology, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1016\/j.joen.2017.08.019","article-title":"A Systematic Review of the Survival of Teeth Intentionally Replanted with a Modern Technique and Cost-Effectiveness Compared with Single-Tooth Implants","volume":"43","author":"Mainkar","year":"2017","journal-title":"J. Endod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1046\/j.1600-4469.2003.00218.x","article-title":"Intentional replantation\u2014A \u2018last resort\u2019 treatment or a conventional treatment procedure? Nine case reports","volume":"20","author":"Peer","year":"2004","journal-title":"Dent. Traumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.adaj.2015.11.017","article-title":"Endodontic Treatment Options after Unsuccessful Initial Root Canal Treatment Alternatives to Single-Tooth Implants","volume":"147","author":"Torabinejad","year":"2016","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.14219\/jada.archive.1966.0125","article-title":"Intentional Replantation of Teeth","volume":"72","author":"Grossman","year":"1966","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"633","DOI":"10.14219\/jada.archive.1982.0252","article-title":"Intentional Replantation of Teeth: A Clinical Evaluation","volume":"104","author":"Grossman","year":"1982","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_6","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","year":"2018","journal-title":"J. Endod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"287","DOI":"10.3109\/00016356609028223","article-title":"Replantation of teeth. II. Histological study of 22 replanted anterior teeth in humans","volume":"24","author":"Andreasen","year":"1966","journal-title":"Acta Odontol. Scand."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1111\/iej.12268","article-title":"Clinical Outcome of Intentional Replantation with Preoperative Orthodontic Extrusion: A Retrospective Study","volume":"47","author":"Choi","year":"2014","journal-title":"Int. Endod. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.joen.2015.01.004","article-title":"Survival of Intentionally Replanted Teeth and Implant-Supported Single Crowns: A Systematic Review","volume":"41","author":"Torabinejad","year":"2015","journal-title":"J. Endod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1016\/j.joen.2016.05.010","article-title":"Survival Rate of Teeth with a C-Shaped Canal after Intentional Replantation: A Study of 41 Cases for up to 11 Years","volume":"42","author":"Jang","year":"2016","journal-title":"J. Endod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1016\/j.joen.2017.08.009","article-title":"Saving Natural Teeth: Intentional Replantation\u2014Protocol and Case Series","volume":"43","author":"Grzanich","year":"2017","journal-title":"J. Endod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.joen.2016.03.006","article-title":"Retention and Healing Outcomes after Intentional Replantation","volume":"42","author":"Cho","year":"2016","journal-title":"J. Endod."},{"key":"ref_13","first-page":"134","article-title":"Root Resorption Classifications: A Narrative Review and a Clinical Aid Proposal for Routine Assessment","volume":"3","author":"Aidos","year":"2018","journal-title":"Eur. Endod. J."},{"key":"ref_14","first-page":"55","article-title":"An Opportunity in Perioimplantology: The PRF","volume":"42","author":"Choukroun","year":"2001","journal-title":"Implantodontie"},{"key":"ref_15","unstructured":"Pinto, N.R., Castro, A., and Leuven, K.U. (2016). Consensus Guidelines on the Use of L-PRF from the 1st European Meeting on Enhanced Natural Healing in Dentistry, Research Gate. Optimisation of Guided Bone Regeneration Techniques View Project."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.joen.2016.11.024","article-title":"Clinical Outcomes after Intentional Replantation of Periodontally Involved Teeth","volume":"43","author":"Cho","year":"2017","journal-title":"J. Endod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/edt.12382","article-title":"Which Is the Most Recommended Medium for the Storage and Transport of Avulsed Teeth? A Systematic Review","volume":"34","author":"Adnan","year":"2018","journal-title":"Dent. Traumatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.joen.2005.12.010","article-title":"Modern Endodontic Surgery Concepts and Practice: A Review","volume":"32","author":"Kim","year":"2006","journal-title":"J. Endod."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Fouad, A.F. (2017). Prognosis of Healing in Treated Teeth with Endodontic Infections. Endodontic Microbiology, John Wiley & Sons, Inc.","DOI":"10.1002\/9781119080343"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Palma, P.J., Marques, J.A., Casau, M., Santos, A., Caramelo, F., Falacho, R.I., and Santos, J.M. (2020). Evaluation of Root-End Preparation with Two Different Endodontic Microsurgery Ultrasonic Tips. Biomedicines, 8.","DOI":"10.3390\/biomedicines8100383"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/etp.12075","article-title":"Bioceramic Materials in Endodontics","volume":"32","author":"Wang","year":"2015","journal-title":"Endod. Top."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/iej.12843","article-title":"Mineral Trioxide Aggregate and Other Bioactive Endodontic Cements: An Updated Overview\u2014Part II: Other Clinical Applications and Complications","volume":"51","author":"Torabinejad","year":"2018","journal-title":"Int. Endod. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Sarnadas, M., Marques, J.A., Baptista, I.P., and Santos, J.M. (2021). Impact of Periodontal Attachment Loss on the Outcome of Endodontic Microsurgery: A Systematic Review and Meta-Analysis. Medicina, 57.","DOI":"10.3390\/medicina57090922"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s00784-020-03365-7","article-title":"Root-End Microsurgery Using a Premixed Tricalcium Silicate Putty as Root-End Filling Material: A Prospective Study","volume":"25","author":"Taha","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_25","first-page":"46","article-title":"Lingual Orthodontics and Forced Eruption: A Means for Osseous and Tissue Regeneration","volume":"9","author":"Paolone","year":"2008","journal-title":"Prog. Orthod."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15761\/JCMM.1000116","article-title":"Platelet-Rich Concentrates (L-PRF, PRP) in Tissue Regeneration: Control of Apoptosis and Interactions with Regenerative Cells","volume":"1","author":"Crisci","year":"2018","journal-title":"J. Clin. Mol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/jcpe.12658","article-title":"Regenerative Potential of Leucocyte- and Platelet-Rich Fibrin. Part B: Sinus Floor Elevation, Alveolar Ridge Preservation and Implant Therapy. A Systematic Review","volume":"44","author":"Castro","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jdent.2016.06.005","article-title":"Dimensional Changes of the Post Extraction Alveolar Ridge, Preserved with Leukocyte- and Platelet Rich Fibrin: A Clinical Pilot Study","volume":"52","author":"Anwandter","year":"2016","journal-title":"J. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1111\/jcpe.12612","article-title":"The Use of Leucocyte and Platelet-Rich Fibrin in Socket Management and Ridge Preservation: A Split-Mouth, Randomized, Controlled Clinical Trial","volume":"43","author":"Temmerman","year":"2016","journal-title":"J. Clin. Periodontol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"369273","DOI":"10.1155\/2015\/369273","article-title":"Influence of Leukocyte- and Platelet-Rich Fibrin (L-PRF) in the Healing of Simple Postextraction Sockets: A Split-Mouth Study","volume":"2015","author":"Marenzi","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.ijom.2018.06.003","article-title":"Effects of Leukocyte\u2013Platelet-Rich Fibrin (L-PRF) in Different Intraoral Bone Grafting Procedures: A Systematic Review","volume":"48","author":"Dragonas","year":"2019","journal-title":"Int. J. Oral. Maxillofac. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Elhakim, A., Kim, S., Kim, E., and Elshazli, A.H. (2021). Preserving the Vitality of Teeth Adjacent to a Large Radicular Cyst in Periapical Microsurgery: A Case Report with 4-Year Follow-Up. 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