A case of aesthetic restoration of attached gingival incision in endodontic microsurgery of upper anterior teeth
Objective To consider the aesthetic problem of gingival soft tissue healing after endodontic microsurgery and suggest an aesthetic restoration method of gingival attachment incision for the case of maxillary anterior teeth requiring endodontic microsurgery due to chronic periapical periodontitis.Methods For the maxillary anterior teeth which require endodontic microsurgery and have been crown-restored,with close edges and enough width of attachment gingiva,the incision was designed as an attachment gingival incision,the buccal bone wall of the apical lesion area was removed,the lesion tissue was completely scraped off,the apex was cut off by 3 mm,and the infected tissue in the apical area was scratched with a spatula.The retro-preparation of 3 mm was made by ultrasonic tip and retrograde filling was made using mineral trioxide aggregate(MTA),the cavity was covered with collagen membrane,and the mucoperiosteal flap was reset and sutured.Results During reexamination carried out 7 months after surgery,the patient had no discomfort.Cone beam computed tomog raphy(CBCT)showed osteogenesis in the apical area,and the gingival margin in the operation area did not shrink obviously.Conclusion The affected tooth is the maxillary anterior tooth,which is in the aesthetic area,with close edge of the restoration and sufficient width of the attached gingiva.The incision is designed as an attached gingival incision,which can better repair the soft tissue and avoid gingival recession.
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