Treatment of an endodontic perforation with a restoration and a root coverage gingival graft

This case report describes the treatment of a perforation on the facial surface of the maxillary right central incisor made during endodontic therapy. Treatment of this highly visible area required a creative approach to therapy. The perforation was repaired with an amalgam restoration. A connective tissue with partial thickness double pedicle graft was used to replace missing periodontal structures, cover the exposed root surface, and obscure from view, as much as possible, the amalgam restoration placed in the perforation. This unconventional therapy is offered as a possible treatment option when few or no other acceptable options exist.