Successful Management of an Extensive Class V Carious Lesion With Dehiscence and Loss of the Attachment Apparatus: A Case Report With Six-Month Follow-Up

The present case report presents a rare instance of a Class V carious lesion combined with alveolar dehiscence in a non-vital maxillary central incisor without gingival recession. A 25-year-old male exhibited symptoms, including a blackened tooth (#21), pus discharge, and tenderness, with clinical examination revealing a Class V carious lesion and partial dehiscence of the labial cortical plate, confirmed by radiographic and cone-beam computed tomography (CBCT) imaging. Treatment involved a two-phase approach: endodontic therapy with root canal instrumentation and obturation using a bioceramic sealer, followed by surgical intervention that included carious lesion removal, restoration with resin-modified glass ionomer cement (RMGIC), and application of a platelet-rich fibrin (PRF) membrane. PRF was selected for its regenerative properties, promoting bone healing and tissue repair, and was particularly beneficial in extensive lesions. Post-treatment follow-up at six months demonstrated complete soft tissue healing, reduced probing depth, and significant bone regeneration. This case illustrates the effective management of a complex dental condition through a combined endodontic and periodontal approach enhanced by PRF therapy, yielding favorable clinical and radiographic outcomes.