Segmental Intentional Replantation for the Management of Large Periapical Cystic Lesions: Technical Report and a Case Series.

AIM: To introduce the concept of segmental intentional replantation (SIR) and to evaluate its clinical feasibility in the management of large periapical cystic lesions.

SUMMARY: This retrospective case series evaluated eight teeth in seven patients (3 males and 4 females; mean age, 53.0 ± 14.6 years) presenting with persistent large periapical cystic lesions that were managed using the SIR procedure. All teeth were successfully replanted with a mean extraoral time of 16 min and 50 s. Following the procedure, all replanted tooth-bone complexes were clinically retained without major complications, maintaining stable probing depths of ≤ 3 mm. Clinical stability assessments using Periotest values (PTVs) and Implant Stability Values (ISVs) indicated functional stability of the replanted teeth without clinical or radiographic signs of ankylosis. Furthermore, radiographic analyses using periapical radiographs and cone-beam computed tomography (CBCT) demonstrated minimal horizontal bone-width alteration and stable marginal bone levels, showing a mean marginal bone-level change of 0.02 mm during the follow-up period.