Year : 2024

Volume : Volume 15

Issue : Issue 6

Address for correspondence :
Aditee Agrawal
aditee.agr1895@gmail.com

Abstract

Background: This case report describes a collaborative, interdisciplinary approach to managing severe Bilateral Palatogingival Grooves (BPGGs) in maxillary lateral incisors. The treatment addressed complexities of combined periodontal-endodontic lesions, including a broken instrument fragment and the potential need for improved regenerative outcomes by utilizing newer dental materials. Materials and Methods: A detailed clinical presentation is provided, encompassing recent diagnostic techniques, treatment planning, and a novel collaborative strategy involving both endodontic and periodontal expertise under a dental operating microscope. Techniques for retrieving the broken file fragment and managing BPGGs with Emdogain® (Straumann AG, Basel, Switzerland) and Biodentine® (Bioactive Dentin Substitute Septodont) are outlined. Results: The minimally invasive approach successfully retrieved the broken file fragment and achieved complete sealing of the severe Palatogingival Grooves (PGGs) extending to the root apices. Follow-up revealed no sinus tract formation, reduced periodontal pocket depth, and near-complete periapical healing in both teeth. Conclusion: This rare case demonstrates an innovative interdisciplinary collaboration in managing complex BPGGs with the additional complication of broken instruments. The use of Emdogain for periodontal regeneration in a severe Type III PGG and newer biosilicate cement with improved handling properties facilitated the preservation of a natural tooth that would otherwise be required by an implant or fixed partial denture therapy.