PMC3467119_01
Tracking test in the gingival fistula
iej-07-40-g001.jpg
PMC3467119_01_iej-07-40-g001.jpg
s2figure5
Also, a 10 mm deep periodontal pocket was observed, and after a tracking test in the gingival fistula (Figure 1), we opted for an exploring surgery to detect the origin of the pus.
A) Granulation Tissue; B) VRF in the vestibular face of the tooth; C) Schematic fracture drawn
iej-07-40-g002.jpg
PMC3467119_01_iej-07-40-g002.jpg
s2figure6
A full-thickness flap was elevated and a granulation tissue was observed at the root buccal surface; also, a total absence of the alveolar bone was observed in this area all through the tooth length except for 3 mm of the radicular apex (Figure 2A). After removing the inflammatory tissues, it was possible to verify the presence of a VRF in the buccal surface of the tooth (Figure 2B). A schematic drawn shows the fracture in detail (Figure 2C).
A) Filling of the cavity with composite resin; B) Cavity with composite resin; C) Low Power laser treatment
iej-07-40-g003.jpg
PMC3467119_01_iej-07-40-g003.jpg
s2figure7
After adhesive polymerization, we filled the cavity with composite resin Tetric Ceran (Ivoclar, Schaan, Liechtenstein), followed by light curing for 40 seconds (Figure 3A and Figure 3B). In order to accelerate tissue repair, minimize possible gingival recession and an anti-inflammatory response after the surgery, 5 sections of low power laser with a wavelength of 685 nm (Photon Lase, DMC, Sa~o Carlos, Brazil) was performed around the tooth with occasional applications at mesial, distal, apical and cervical with intervals of 48 hours between sessions (Figure 3C).
Two years follow-up; A) Radiographic; B) Clinical
iej-07-40-g004.jpg
PMC3467119_01_iej-07-40-g004.jpg
s2figure8
The patient was followed for two years (Figure 4A and Figure 4B).