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Regeneration is a viable treatment modality that allows continued root development of immature teeth with open apices and necrotic pulps. Platelet-rich plasma appears to be a suitable scaffold for regeneration of vital tissues in teeth with a necrotic pulps and an associated periapical lesion. Regenerative endodontic procedures may offer an effective treatment option to save teeth with compromised structural integrity.

•  Fused and geminated teeth requiring endodontic treatment present diagnostic and technical challenges. • An exact differentiation between fusion and gemination may not be critically important for treatment. • The use of an operating microscope for detection of additional root canal orifices in complicated cases is recommended.

Autogenous tooth transplantation refers to the repositioning of autogenous teeth in another tooth extraction site or a surgically formed recipient site to replace missing teeth due to congenital deformity, grossly decayed carious teeth, mobile teeth due to periodontal disease, teeth lost due to trauma, endodontic failure or any other reason when a suitable donor tooth is available. This is a case report of autotransplantation of impacted #38 with complete root formation into the extraction site of grossly decayed, unrestorable #37 with 18 months follow-up showing excellent periapical healing and tooth stability. In autogenous tooth transplantation, even if the donor's tooth has complete root formation, a high success rate can be achieved if the cases are selected and treated properly. Chances of root resorption are there because of necrotic pulp and periodontal irritation during manipulation. However, autogenous tooth transplantation should always be considered as a good treatment modality in feasible cases.