A multidisciplinary approach of an endo-perio lesion in a severely compromised tooth: An 18-Year Follow-up Case Report




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Journal of Medicine and Life, 2671-4922, Vol. 13, Nro. 4, 2020, p. 629–634

Publicado por

NLM (Medline)

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This case report describes the diagnosis, multidisciplinary treatment, and long-term follow-up of a severely compromised tooth in a patient who was referred for assessing a gingival recession. Clinical evaluation of the left maxillary canine showed 12 mm of mid-buccal gingival recession, probing depth of 14 mm on the mesial-buccal aspect, and grade III mobility. A periapical radiograph revealed extensive periapical and lateral radiolucency. The first step of the treatment was to carry out oral hygiene instructions and full-mouth debridement. After that, endodontic treatment was performed immediately. Periodontal reevaluation four months after endodontic therapy revealed that probing depths of all sites were within 3 mm and periapical radiograph showed a slight decrease in periapical and lateral radiolucency. It was subsequently decided to perform root coverage with a laterally positioned flap and subepithelial connective tissue graft. Six months after surgery, the root surface showed 1 mm recession, representing root coverage of 91.7% and a gain of attachment of 13 mm. The patient was enrolled in a 6-month supportive periodontal therapy. Treatment outcomes were evaluated over 18 years, with successful radiographic and clinical results throughout the follow-up period. The successful management of endo-periodontal lesions requires an accurate diagnosis, which is imperative to provide proper therapy in the correct treatment sequence.

Palabras clave

Lesión endoperiodontal, Recesión gingival, Obturación del conducto radicular, Terapia mucogingival, Informe de caso


Endo-periodontal lesion, Gingival recession, Root canal obturation, Mucogingival therapy, Case report