Apical Combined Mucogingival Microsurgery Treat Apical Lesion With Gingival Recession

The apical lesion of two incisors was treated by apical microsurgery and the inevitable gingival recession due to irregular abscess incision after apical microsurgery was treated by mucogingival surgery. The patient's bilateral central incisors underwent root canal therapy, root canal retreatment, and post-and-core crown restoration, subsequently developing periapical lesion and fistula. The patient had previously undergone incision and drainage at another hospital, with the incision located in the free gingiva and the crown restoration beneath it. The incision did not heal for a long time. Consideration was given to performing apical microsurgery to treat the periapical lesions, but gingival recession occurred postoperatively. Three months after the apical microsurgery, combined mucogingival surgery was performed to treat the gingival recession and restore aesthetics. After multiple follow-up examinations over the past 5 years post-surgery, the periapical lesions have shown good recovery, and the gingiva appears aesthetically pleasing. In this case, due to previous treatment issues, microsurgical apical surgery emerged as the optimal treatment plan to preserve the affected tooth. However, postoperative gingival recession was unavoidable. Through a second-stage mucogingival surgery, the patient's anterior teeth were improved in aesthetics, ultimately achieving excellent long-term treatment outcomes. In aesthetic area, apical microsurgery treats periapical lesion and combined mucogingival surgery solve the aesthetic problems of postoperative gingival recession.