title: Salvaging a tooth with a deep palatogingival groove: an endo-perio treatment--a case report.
abstract: OBJECTIVE
  To describe the diagnosis and management of tooth 22 with a necrotic pulp and severe periodontal destruction associated with a deep palatogingival groove extending to the root apex.
  
  
  CONCLUSIONS
  Palatogingival grooves are uncommon in maxillary lateral incisors, but when present may contribute to the pathogenesis of periodontal and endodontic lesions. In the present case, the prognosis was considered poor, as the patient presented with a deep probing defect, advanced bone loss and grade III mobility of tooth 22. Root canal treatment was performed, followed by periodontal surgery, during which the groove was conditioned and sealed with conventional glass-ionomer cement and the osseous defect filled with indigenously prepared hydroxyapatite. The 18 month post-operative follow up showed substantial resolution of the osseous defect with gain in attachment and decreased tooth mobility.
  
  
  CONCLUSIONS
  Teeth with deep palatogingival grooves may be significantly compromised with severe periodontal and periapical bone loss. Following thorough evaluation, the careful application of endodontic and periodontal surgical procedures may restore satisfactory function.
authors: Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India. drballal@yahoo.com
authors: N V
authors: NV
authors: Ballal
authors: V
authors: V
authors: Jothi
authors: K S
authors: KS
authors: Bhat
authors: K M
authors: KM
authors: Bhat
mesh_terms: D005260:Female; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010510:Periodontal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010512:Periodontal Index; D011859:Radiography; D012390:Root Canal Therapy / Q000379:methods*; D014071:Tooth Abnormalities / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*