Functional and esthetic restoration of a periodontally involved hopeless tooth with a staged multidisciplinary treatment approach

Periodontally hopeless teeth are often deemed candidates for extraction. However, patients’ desire and clinicians’ perseverance might sometimes result in unexpected outcomes beyond simple retention of the tooth. A pathologically migrated Grade II mobile upper incisor with a perioendo lesion in a 31-year-old female patient was sequentially treated with endodontic treatment, local drug delivery, and regenerative surgery using xenograft, injectable platelet-rich fibrin (I-PRF), and chorion membrane. The postsurgical recession was managed using the vestibular incision subperiosteal tunnel access (VISTA) technique with a collagen membrane and I-PRF, followed by indirect composite veneers for tooth discolouration and a fixed lingual retainer to prevent future migration. The mentioned treatment approach restored the function and esthetics of a hopeless tooth by eliminating the pocket and mobility, resolving the perioendo lesion and bone defect, and facilitating root coverage.