Combined Periodontal-Restorative Therapy For Mandibular Second Molar Distocervical Caries

Distocervical caries in mandibular second molars induced by impacted third molars present significant therapeutic challenges due to limited access. This report introduces a novel 5-year follow-up of combined therapy for such case, establishing its clinical validity. A 37-year-old female presented with persistent sensitivity in tooth 37 following composite resin filling after the extraction of the impacted left mandibular third molar. Clinical/radiographic evaluations revealed subgingival defective filling, extensive caries, and marginal gap. Treatment included: 1. Full-thickness flap elevation for lesion exposure 2. Dental operative microscope-assisted removal of defective filling and caries excavation 3. Composite resin restoration using adhesive technique 4. Flap repositioning and suturing Five-year follow-up confirmed intact restoration, normal periodontal status, and no radiographic recurrence. Key advantages of this approach: 1. Surgical exposure improved visualization and precision for subgingival caries management 2. Preservation of distal marginal ridge maintained tooth structural integrity 3. Adhesive restoration combined with periodontal care ensured long-term success. Combined periodontal-restorative therapy offers an alternative to extraction for mandibular second molar distocervical caries induced by impacted mandibular third molars. The technique preserves tooth function while minimizing invasive procedures, making it particularly suitable for younger patients.