Dens invaginatus (DI) represents a rare developmental anomaly that may predispose affected teeth to pulpal and periapical pathologies. When complicated by external inflammatory root resorption (EIRR), treatment becomes considerably more challenging and prognosis may be compromised. Intentional replantation (IR) has reemerged as a conservative alternative in cases where conventional nonsurgical endodontic retreatment or periapical surgery is not feasible. A 20-year-old systemically healthy male presented with intraoral swelling in the maxillary lateral incisor region. Cone beam computed tomography (CBCT) revealed a periapical lesion approximately 12 mm in diameter associated with a maxillary lateral incisor exhibiting Oehlers Type I DI and severe EIRR. The tooth was atraumatically extracted, and granulation tissue on the root surface was removed using ultrasonic tips under continuous saline irrigation, followed by apical resection. A 3-mm retrograde filling using mineral trioxide aggregate (MTA) was placed. All extraoral procedures were completed within 14.5 min. The patient was followed at 1, 3, 6, 12, and 18 months. Radiographic evaluation demonstrated complete periapical healing and cortical bone regeneration at the 18-month follow-up. This case demonstrates that IR can be a reliable and conservative option for the management of complex endodontic cases involving dens invaginatus and extensive inflammatory root resorption.
Karakoyunlu et al. (2026) studied this question.