“…Research has shown that intentional teeth replantation in less than 15 minutes is another reliable tooth-preserving therapy for unsuccessful bypass of SI or apical microsurgery with periapical pathosis. 9 Concerning the information in this brief letter, the management of SI can be summed up as follows: 1) a proper treatment protocol, 2) selecting the appropriate concentration of irrigation solution, 3) using a negative pressure irrigation system (e.g., EndoVac), 4) using individually or in combinations of ultrasonic tips, wire loop method, braiding technique, or XP-endo Shaper to remove SI, 5) using appropriate endodontic system (e.g., Hyflex, Genius, and ESP files), and 6) intentional replantation in the case of unsuccessful bypass of SI with periapical pathosis. Hence, accurate evaluation of the clinical and imaging diagnosis, sufficient clinician knowledge of endodontic procedures, and using a microscope can reduce the possibility of SI during root canal treatment.…”