Extraction and replantation of a periapically infected tooth

At times, an infected tooth that may be deemed unrestorable may be salvaged by atraumatic removal, an in‐hand apicoectomy and retrograde seal, then replantation. This patient was referred to this author for an extraction and implant treatment of the maxillary left second premolar. After a discussion, the patient preferred to salvage the tooth if possible. The tooth was successfully atraumatically removed, and an in‐hand apicoectomy and retrograde amalgam seal was placed. The tooth was immediately replaced into its socket and was stable. The occlusal surface was flattened to prevent and off axial loading. A bis‐acryl brace was applied to the facial and lingual aspect to prevent an overload while the tooth was healing. The patient was admonished to maintain a soft diet. After 3 weeks, the braces were removed, and the tooth was found to be stable. After 8 weeks, the tooth was asymptomatic, and the patient was able to revert to her normal diet without pain. While extraction, placing an apical seal and replantation of teeth is not a new modality; nonetheless, clinicians may need to be reminded of this procedure to increase the number of options presented to patients.