RELATO DE CASO DA CIRURGIA DE REIMPLANTE INTENCIONAL REALIZADO NO DENTE 21 COM EXTENSA REABSORÇÃO CERVICAL INVASIVA

Abstract

Invasive Cervical Resorption (ICR) is a progressive condition characterized by substitution of root dentin with resorptive tissue of odontoclastic origin, typically associated with dental trauma, orthodontic treatment, or internal bleaching. Due to its subgingival and frequently asymptomatic behavior, diagnosis is often delayed. ConeBeam Computed Tomography (CBCT) allows precise assessment of the lesion’s extent and its relationship with the root canal. This article presents the clinical management of a 35-year-old male patient with a history of trauma to tooth 21 fifteen years earlier, showing discoloration, slight mobility, and a mesial cervical radiolucency consistent with Class 3 ICR. After a multidisciplinary evaluation, endodontic therapy followed by Intentional Replantation (IR) was selected as a conservative treatment option to preserve function and esthetics at lower cost than Implant-supported rehabilitation. The procedure included atraumatic extraction, a total extraoral time of 14 minutes and 53 seconds, debridement of resorptive tissue under magnification, sealing of the defects with Bio-C Repair bioceramic cement, and cervical restoration using bioactive resin materials. Six-month clinical and radiographic follow-up revealed no symptoms, periodontal stability, and absence of progression in bone resorption, despite minor local remodeling. This case highlights that Intentional Replantation, when properly indicated and carried out under strict technical and biological principles, is a predictable approach for advanced ICR, allowing preservation of the natural tooth, bone support, and esthetic harmony. Long-term monitoring remains essential for early detection of late complications such as ankylosis or replacement resorption.