Peg Lateral- Whether to Extract or to Preserve?

Abstract

Introduction: Cosmetic desires have improved over time and currently, in the modern world, patients not only demand for an assertive smile but also express a desire to save their natural dentition in favour of extraction whenever and wherever possible. Peg lateral, an undersized, tapered, maxillary lateral incisor, not only often presents with periodontal complications but also down-regulates the self-esteem of the patients. Aim: To restore a fully functional and esthetically pleasant peg lateral. Methodology: A 17-year old female patient complained of mobility and bleeding from upper front teeth region during brushing since last 6 months. So it was decided to perform thorough scaling and root planing, root canal treatment #12, followed by open flap debridement with alloplastic bone graft placement #12. Surgical area was allowed to heal for 15 days and after that composite build-up of peg lateral was done to give it a proper shape. Results: Uneventful healing was seen in terms of periodontal consideration. Mobility of teeth #12 was reduced after 4weeks and there was no complaint of bleeding during brushing or mastication. Conclusion: This case highlights the interdisciplinary approach of root canal treatment, open flap debridement, bone regeneration with composite build-up as an innovative approach providing better results with minimum patient apprehension and long term stability.