# Heroic Saves in Endodontics: Management of Advanced External Cervical Resorption With Intentional Replantation: A Review and Report of Two Cases

## TL;DR

This paper presents two cases where intentional replantation successfully managed advanced external cervical resorption, offering a treatment alternative to tooth extraction.

## Contribution

The study demonstrates the efficacy of intentional replantation in treating severe external cervical resorption through real-world clinical cases.

## Key findings

- Intentional replantation preserved compromised teeth with advanced ECR in two patients.
- Short-term functional preservation and temporary arrest of resorption were achieved post-treatment.
- Early diagnosis and microsurgical principles are critical for successful outcomes in ECR management.

## Abstract

External cervical resorption (ECR) is a complex and aggressive form of root resorption that poses significant challenges in clinical management. This case report describes two cases of advanced ECR treated with intentional replantation (IR), highlighting its efficacy as a viable treatment option for preservation of compromised teeth. The first case involved a 10‐year‐old girl with a Heithersay Class IV/Patel 3Cd lesion following dental trauma, and the second case involved a 30‐year‐old male with a Heithersay Class IV/Patel 3Bd lesion. Both cases were managed with IR, which included atraumatic extraction, extraoral restoration of defect, and reimplantation within 15 min. Postoperative follow‐ups demonstrated short‐term functional preservation and temporary arrest of resorptive activity; however, long‐term outcomes could not be assessed due to limited follow‐up. The discussion emphasizes the importance of early diagnosis, multidisciplinary collaboration, and adherence to microsurgical principles to optimize the success of IR. Additionally, the utility of Heithersay and Patel’s classification systems in guiding treatment decisions is underscored. These cases illustrate that even in severe ECR, strategic surgical intervention can achieve favorable results, offering clinicians a valuable alternative to extraction.