Surgical approuch to seal the crestal perf (by Ilya Mer)

Русская версия

The silver point definetly perforated the buccal wall and refered dentist  believed that perforation was in the midroot. So did I

Preoperative images
But having removed the cast post I have found the bud of silver point only 2 mm down to the margin! (white arrow)
I have tried to pull it out with Stieglitz pliers but didn’t succeed. I even tried to glue it and to hold it with help of Cianoacrilate glue but the silver point remained unwinnable. On the next visit I have completed the obturation.
Rised the flap. To my big surprise trying to retrieve it I didn’t succeed. It stuck very hard.
Finally I had to drill it out with a small bor. So we have the perforation which is located under the bone level and down to gingiva level. Perforation of this kind being closed with MTA can be easily contaminated and true periodontal pocket can develop. The material of choice for intrasulcular perforations is composite.
I also performed light crown lengthening
postoperative images
12 month recall, good epithelian attachment - sulcus depth was about 2-3mm, exсept for perforation that it was is about 4mm but that was expected

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