Palatoradicular Groove-Associated Periodontic-Endodontic Lesion: A Multidisciplinary Case Report Utilising Minimal Access Papilla-Sparing Regenerative Technique (MAPSRT) and Dual-Flap Approach.

This case report describes the management of a palatoradicular groove on a lateral incisor tooth (#12) in a nonperiodontitis patient. Despite the commencement of endodontic treatment, the tooth showed no signs of resolution and was referred to the Oral Health Centre of Western Australia for specialist management. Tooth 12 presented with a periodontal probing depth of 7 mm at the mid-palatal site with suppuration. Nonsurgical periodontal therapy adjunct with the application of 0.5% chlorhexidine gel was completed, followed by the completion of endodontic treatment one week prior to regenerative therapy. A minimal access papilla-sparing regenerative technique (MAPSRT), a novel, site-specific modification, was used for the management of the palatoradicular groove. Periodontal instrumentation, odontoradiculoplasty, placement of fissure sealant material and application of an enamel matrix derivative combined with bone grafting material were performed during regenerative therapy. Tooth 12 was restored with a full-coverage monolithic zirconia crown 6 months after regenerative therapy. This procedure had a successful outcome with a reduction in probing depth on the mid-palatal site of Tooth 12 to 3 mm, bone remodelling in the defect areas and minimum scarring at the 6-month review appointment. This case highlights the importance of an interdisciplinary approach in the management of periodontal destruction associated with palatoradicular grooves.