A patient presented with early to moderate periodontitis localized around tooth No. 30. This tooth had a cast restoration with an open proximal contact for the previous seven years. Radiographs spanning this time period showed progressive bone loss. Surgical periodontal therapy was performed after correction of the open proximal contact with a provisional restoration. A new porcelain-fused-to-metal crown was placed three months after surgical therapy. The patients has been on a regular six-month recall schedule for three years and has maintained a healthy periodontium. Prior food impaction has been eliminated and the patient is without complaints.