Introduction: Preserving the dentition and ensuring that it fulfills its functions are the main objective of endodontic treatment. When the periapical lesion persists, it is necessary to review the retreatment alternatives.

Objective: To analyze the literature and compare the efficacy of non-surgical endodontic procedures, such as apical surgery, intentional reimplantation and dental extraction with implant placement as procedures for retreatment of periapical lesions.

Methodology: A literature review was carried out in PubMed and Google Scholar databases using the keywords: "periapical lesion", "intentional replantation", "apical surgery", "non-surgical root canal treatment" "tooth extraction", and Boolean parameters AND, OR and NOT.

Results: Non-surgical endodontic retreatment is usually the first choice, files are used to remove the obturation material, although in some cases, since it is not possible to remove it completely, it is not enough to properly disinfect the canals. Apical surgery is a viable option in cases where non-surgical root canal treatment is not possible, such as calcified teeth or extruded material. Intentional reimplantation offers the advantage of working in areas that are difficult to access and decreasing working time. Tooth extraction and implant placement should be considered as a last option, as it can generate loss of function and esthetic problems. Implant placement maintains the bone structure and soft tissues for a longer period of time.

Conclusion: The adequate selection of cases to apply the different treatments will improve the prognosis. Preserving teeth in the best possible condition at the time will always be the best option.