Endodontic and periodontal treatment of complete buccal root and apex exposition: a challenging case report with 17 months follow-up

Sérgio Kahn, Alexandra Tavares Dias, Vitor Nobre, Larissa Zarjitsky de Oliveira, Gustavo Vicentis de Oliveira Fernandes

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: This case report demonstrated a challenging clinical case addressed within a multidisciplinary approach to achieve its maintenance, even though had a poor prognosis. It was associated with the endodontic treatment with mucogingival techniques, including periodontal microsurgery and connective tissue graft. Case presentation: A patient presented a deep gingival recession with the apex-exposed non-vital tooth with interproximal bone loss (RT2) and without mobility. The treatment involved an initial endodontic approach and periodontal therapy (scaling and root planing), microsurgical techniques with coronally advanced flap (CAF), root preparation with PrefGel® (24% EDTA), enamel matrix derivatives (Emdogain®), and connective tissue graft. As a clinical result, it was verified an increase of keratinized tissue width and gingival thickness, and root coverage, reaching good esthetics and a stable result after 17 months. Conclusion: The correct diagnosis and technique selection may affect directly the outcome, especially in challenging cases. Even though there was a poor prognosis, an adequate treatment plan, patient cooperation, and technique mastery help to achieve a high level of root coverage, esthetic recovering, and successful outcome.
Original languageEnglish
JournalClinical advances in periodontics
DOIs
Publication statusAccepted/In press - 23 Jun 2021

Keywords

  • Tooth apex
  • Gingival recession
  • Root resorption
  • Nonvital tooth
  • Esthetics

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