Introduction:

Dental implants are an alternative for replacing a missing tooth, but one of the requirements is an adequate amount of soft and hard tissues to support the implant. Otherwise, a surgical procedure must be carried out to obtain appropiate conditions, and any endodontic infectious process must be controlled or eliminated.

Clinical case:

We treated a patient diagnosed with mucoginvival deformity on tooth #12 (Miller’s class I gingival recession) and pulpal necrosis with asymptomatic apical periodontitis, all indicating an unfavorable prognosis forthe upper lateral incisor. The amount of keratinazed gingiva was insufficient to carry out the guided bone regeneration and subsequent placement of the dental implant; therefore, the treatment of the canals was done to eliminate the present infection and later mucogingival procedures were performed to gain the adequate amount of gingiva inserted.

Conclusions:

The endodontic infectious process and the inflammatory process in the soft tissues were controlled. The mucogingival procedures to recover the lost soft periodontal tissues were carried out to facilitate later regenerative periodontal procedures. The tooth was initially scheduled for extraction and placement of a dental implant, but the results were favorable and after two years of follow-up we decided to leave the tooth and, only if necessary, to return to the initial treatment in the future.

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