In a previous email I shared this case as it was in progress. 

The patient presented with a deep periodontal defect on tooth #11 as well as caries apical to the  crown margin. 

She was a very attractive individual who was very concerned about her aesthetics. At the time  she was unhappy with the appearance of the crown that was there and unaware of the difficulty  of treating this tooth again without creating an unattractive aesthetic problem. 

Someone suggested removing the tooth and doing an implant. That would have created even a  bigger aesthetic challenge. 

The decision was made to orthodontically erupt this tooth and bring down the decay and  eliminate the periodontal defect non-surgically. 

This is a photo of the case during as the orthodontist is erupting #11 over a period of nine  months. 

Finally the tooth is brought down.

The temporary was beautifully done aesthetically in terms of the soft tissue.  

The x-rays reveal clearly the defect periodontally is gone and there is more than adequate tooth  structure to prepare a crown without invading the attachment or ending up with an aesthetically  long tooth. 

This approach is all too infrequently used to deal with issues of uneven gingival margins and  defects involving a single tooth. 

The case is only in temps now. Crown lengthening is going to be done just to create symmetry  between the left and right side and then she will get a final restoration. 

As always, I appreciate your feedback 

Yours truly, 

Dr. Victor M. Sternberg 

By Westchester Center for Periodontal & Implant Excellence

December 31, 2023