CASE REPORT article
Front. Oral Health
Sec. Oral and Maxillofacial Surgery
Volume 6 - 2025 | doi: 10.3389/froh.2025.1676465
Intentional Reimplantation of a Mandibular Premolar with Severe Apical Root Resorption: A Case Report DemonstratingEmphasizing Diagnostic Complexity in Adjacent Teeth
Provisionally accepted
- Ajman University, Ajman, United Arab Emirates
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Purpose: This case report aimed to illustrate the clinical application of intentional reimplantation (IR) as a conservative and effective treatment strategy in cases of significant apical root resorption when surgical endodontics poses a risk to adjacent anatomical structures. This case report aimed to illustrate the clinical application of intentional reimplantation (IR) as a conservative and effective treatment strategy for mandibular premolars with significant apical root resorption. Furthermore, it addressed the diagnostic challenge concerning the neighboring tooth, underscoring the importance of a comprehensive diagnostic evaluation to accurately differentiate between pathologies and prevent misdiagnosis. Case Presentation: A 25-year-old woman presented with tooth #44 that had previously initiated root canal therapy. Cone beam computed tomography was used to verify both internal and external resorption patterns, whereas clinical and radiographic assessments revealed extensive apical resorption. The patient underwent re-implantation after receiving root canal therapy. Tooth #43 presented a diagnostic challenge, as it appeared non-vital based on sensibilitysensitivity testing. However, a positive response was observed during the test cavity preparation.diagnostic drilling test. At the 15-month follow-up, tooth #44 showed clinical and radiographic healing with no visible symptoms of ankylosis or resorption. The sensibilitysensitivity test results for tooth #43 returned to normal, validating the initial false-negative findings. Conclusion: With a careful technique, appropriate case selection, and thorough follow-up protocols, intentional reimplantation is a legitimate and reliable tooth-preserving treatment option for complex endodontic failures, especially those involving extensive root resorption. This case also emphasizes the value of a thorough diagnostic approach, particularly in cases where the results of the sensibilitysensitivity test conflict with the radiographic and clinical findings in neighboring teeth.
Keywords: Root Resorption, Tooth Replantation, Endodontics, Pulp Vitality Tests, Cone-BeamComputed Tomography, Non-surgical root canal treatment, apical periodontitis, IntentionalReplantation
Received: 30 Jul 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Ameen, Elmsmari and Rahman Saleh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Firas Elmsmari, f.elmsmari@ajman.ac.ae
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