Reimplantation of an avulsed tooth is a well known and accepted treatment following a traumatic dental injury. Preservation of vital cells in the periodontal ligament allow reattachment of the tooth in the alveolar socket. Rates of success at 5 years reported in the literature ranges between 70% – 91% (1).
The main factors limiting the success of this treatment are the amount of time the tooth is out of the mouth, disruption of the periodontal ligament and bacterial contamination.
Although not common or well known, intentional removal and reimplantation of a tooth is an effective mode of treatment for teeth that cannot be treated with traditional endodontic surgery. This strategy can be particularly helpful in lower second molars where proximity to the mandibular nerve and thickness of the buccal bone make endodontic surgery difficult.
Intentional reimplantation allows the clinician to control the variables that would limit the success of a reimplantation following traumatic avulsion. Atraumatic extraction, minimal time out of the mouth and aseptic technique, allow a clinician to perform apical procedures that otherwise could not be performed.
Again, while not commonplace, intentional reimplantation is a treatment option that can be considered in special cases. It may offer your patient a final opportunity to retain a natural tooth, when endodontic surgery is not an option.
.
