Background: This study reports the case of a 14-year-old girl in good state of health who presented with the apical third of the buccal root of the first upper right premolar that penetrated the alveolar buccal plate and overlying mucosa, being exposed to the oral environment. The treatment rationale is presented and compared with other therapeutic options described in the literature.
Methods: Endodontic treatment and root end resection in association with a guided tissue regeneration protocol were recommended to preserve the tooth.
Results: The evolution was favorable after surgery while the alveolar and mucosal defects were corrected through tissue regeneration and remodeling. A two-year follow-up period with every six months radiographic evaluation was considered.
Conclusions: The therapeutic approach gave satisfactory results. The literature describes conservative treatment modalities in cases with mucosal fenestrations affecting permanent teeth.