Intentional Tooth Replantation: Current Evidence and Future Research Directions for Case Selection, Extraction Approaches, and Post-Operative Management

Background: Intentional tooth replantation (ITR) is a promising treatment option for preserving teeth in cases where conventional endodontic therapy is challenging, or when previous endodontic treatment and apicoectomy have been unsuccessful. The procedure involves extracting the compromised tooth, preserving the alveolar socket and root surface, performing extraoral endodontic therapy, and replanting the tooth in the alveolar socket. Objective: An increase in evidence-based support for ITR has improved the viability of ITR as a treatment option for patients. This review aims to further establish and provide new areas of potential research for ITR with respect to root morphology, extraction, and surgical techniques, maintenance of the tooth socket, and methods for post-op stabilization. Materials and Methods: A literature review was performed across PubMed from 1 January 1980 to 1 July 2025, with a focus on oral surgery techniques, atraumatic extraction techniques, topographical discrepancies in root system anatomy, and ITR procedural outcomes. Conclusions: Although ITR is not a common procedure performed in contemporary clinical practice, gathering sufficient data on the variables influencing the procedure may help patient outcome and improve communication between the endodontist and oral surgeons.