Intentional replantation is the last defense for natural tooth preservation. The procedure involves completely extracting the affected tooth, followed by an in vitro examination and evaluation of the root. After removing the lesions, the root canal is treated with retrograde filling, and then the affected tooth is reimplanted into the primary alveolar socket to control infection, preserve the tooth, and restore masticatory function. With the evolution of the endodontic microsurgery concepts and the development of biomaterials, the therapeutic efficacy of intentional replantation has become significantly enhanced.