Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible. 1. Introduction The root canal systems of the teeth usually remain patent and accessible, but if they are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment [1]. Although pulp space of this kind of teeth sounds completely obliterated in preoperative radiographs, this space has adequate room to allow passage of millions of microorganisms [2]. Therefore, a calcified tooth with pulp necrosis inevitably leads to induction of apical periodontitis [1]. The first option for treatment of a calcified necrotic tooth is the conventional root canal therapy [3], but teeth with severe calcification may present challenges with locating and negotiating root canals. The other options beside nonsurgical endodontic treatment include root resection using a surgical method [4] and intentional extraction and replantation [5]. Intentional replantation procedure is usually considered as a last resort [6], but in some cases that conventional endodontic treatment or apical surgery is impossible or impractical, intentional replantation may be considered as a solution to preserve the tooth [6]. The present case report describes a successful treatment of a calcified necrotic mandibular second premolar using intentional replantation procedure. 2. Case Presentation A 44-year-old female with no contributing medical history was referred to the Endodontic Department of Qazvin school of Dentistry. She stated that her right
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