Suzane Cristina Pigossi1*, Luana Carla Pires2, Thais Piragine Leandrin3, Laurie Garcia Belizário3, Thamiris Cirelli2 and Milton Carlos Kuga3
1Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University (Unifal-MG), Brazil
2Department of Diagnosis and Surgery, School of Dentistry, UNESP- São Paulo State University, Brazil
3Department of Restorative Dentistry, School of Dentistry, UNESP- São Paulo State University, Brazil
Incorrect endodontic treatment can lead to root perforation that, in the anterior region, can cause significant esthetic damage. In such cases, a multidisciplinary approach using materials with good sealing ability and biocompatibility is fundamental for both functional and esthetically satisfactory treatment. The present case report describes the multidisciplinary treatment of an iatrogenic root perforation in a central incisor. During the clinical and radiographic examination, a root perforation associated with gingival fenestration was observed in the vestibular region of tooth 11 resulting from endodontic treatment. A flap of total thickness was made in the region, without any relaxing incisions, to allow access to and sealing of the perforation with cement based on tricalcium silicate (Biodentine®). A subepithelial connective tissue graft was removed from the patient's hard palate in order to correct fenestration in the marginal gingiva. After 3 months, tissue healing and stability of the obturation were observed, with no signs of root resorption, but with a retraction in the gingival margin of tooth 11. Therefore, a clinical crown augmentation of the anterior teeth was performed for correction of the gingival zenith and harmonization of the pink esthetics. Restorative procedures with feldspathic ceramic veneers for correction of the color and shape of the anterior teeth were performed 3 months later. It was concluded that the multidisciplinary approach allows treatment of the perforation and restoration of the harmony and esthetics of the smile, guaranteeing patient satisfaction.
Esthetics; Root canal perforation; Gingival graft
Pigossi SC, Pires LC, Leandrin TP, Belizario LG, Cirelli T, Kuga MC. Multidisciplinary Approach for Treatment of Root Perforation in Esthetic Areas: A Clinical Report. Clin Surg. 2019; 4: 2322.