Combined Endodontic Therapy and Intentional Replantation for the Treatment of Palatogingival Groove

A palatogingival groove is an anatomic malformation that predisposes the involved tooth to a severe periodontal defect. When the condition is complicated by pulpal necrosis, affected teeth often present a dilemma in terms of diagnosis and treatment planning. In this report, we describe the case of a patient with a maxillary lateral incisor with a deep palatogingival groove extending to the root apex and severe periodontal destruction (local pocketing). Suggested treatment modalities included curettage of the affected tissues, elimination of the groove by grinding and/or sealing with a variety of filling materials, and surgical procedures. In this case, a combined treatment approach, involving both endodontic therapy and intentional replantation after restoration with a self-etching flowable composite, resulted in periodontal healing and significant healing of the periradicular radiolucency at 12 months. In short, intentional replantation offers a predictable procedure and should be considered a viable treatment modality for the management of palatogingival grooves, especially for single-rooted teeth.