Intentional Re-implantation and Extra-oral Rehabilitation of Endodontically Ill-Treated Mandibular Molar with 36 Months Follow-up: A Case Report

This case report demonstrates intentional extraction of an endodontically compromised tooth followed by its intentional reimplantation to preserve the tooth and restore its functions. Re-implantation presents an alternative treatment option to preserve integrity of dentition in cases of poor prognosis where the tooth is damaged with multiple perforations or due to limited instrument access or proximity to vital structures. This technique can help preserve permanent teeth in pediatric patients for support in the long run. Extraction of tooth eliminates the source of infection and facilitates extra-oral repair of the tooth diminishing the chances of resorption and re-infection when supplemented with Mineral Trioxide Aggregate as a perforation repair material; and triple antibiotic paste and chlorhexidine for adequate sterilization. The tooth is maintained in the oral cavity and its functions of mastication, support and esthetics are preserved. Re-implantation supported by adequate splinting ensures proper bone deposition around the re-implanted tooth, thus, aiding in increasing the life span of the tooth in the arch. Intentional re-implantation has been shown to be a successful treatment modality in cases of endodontic failures to salvage the tooth with excellent follow-up results as in this case.