INTENTIONAL REPLANTATION OF A CALCIFIED MANDIBULAR PREMOLAR – STEP-BY-STEP PROTOCOL

A 38-year-old ASA I female presented with chronic symptoms on tooth 35. Two previous orthograde treatment attempts had failed. Clinical examination revealed tenderness to percussion and palpation, with negative pulp sensibility tests. Diagnosis: acute apical periodontitis on a previously initiated treatment (AAE, 2019). CBCT analysis revealed severe canal obliteration associated with a periapical lesion in close proximity to the mental foramen. Given the extent of calcification, further orthograde negotiation was considered highly unpredictable and exposed to significant iatrogenic risk. Endodontic microsurgery was contraindicated due to the anatomical proximity of the mental foramen. According to the biological principles established in dental traumatology, preservation of periodontal ligament vitality is the key determinant of long-term success in intentional replantation (Andreasen et al., 1990).…