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Background: Periodontal tissue and pulp are interconnected anatomically. In some circumstances, the inflammation may extend from the periodontal region to the pulp or vice versa. In perio-endo lesions, an appropriate treatment plan is required to obtain a predictable and reliable treatment prognosis. The development and progression of these perio-endo lesions can be influenced by many factors such as bacteria, fungi, viruses, trauma, root resorption, perforation and dental malformations. An appropriate treatment plan for perio-endo lesions can provide a good prognosis. Objective: To describe periodontal treatments performed in patients with perio-endo lesions. Case Report: A 39-year-old man presented to Hasanuddin University Dental and Oral Hospital with a chief complaint of uncomfortable left posterior maxillary teeth during mastication. Clinical examination showed vital, non-caries, pocket depth of ±9mm on tooth 26. Radiographic examination showed a radiolucent lesion that extended to the apically. Regenerative periodontal treatment was performed using a combination of platelet-rich fibrin (PRF) with demineralized freeze-dried bone xenograft (DFDBX). Results: During the observation period, pocket depth was reduced, and the pain was absent. Conclusion: Periodontal inflammation that extends to the pulp tissue can be prevented by regenerative periodontal treatment using a combination of PRF and DFDBX, which shows promising results. Keywords: endo-perio lesions, periodontal regenerative, periodontal surgery

Background: Non-carious cervical lesions (NCCLs) are commonly associated with multiple gingival recessions. These cases cause aesthetic issues, dentin hypersensitivity and increased plaque accumulation. Therefore, they require multidisciplinary treatments. Zucchelli proposed the combined periodontal–restorative approach using envelope coronally advanced flap (CAF) in managing multiple gingival recessions with NCCLs. Objective: This case report highlights the effectiveness of Zucchelli’s modified envelope CAF in combination with a restorative approach for the treatment of multiple Miller class- III gingival recessions with type-3 NCCLs. Case Report: Zucchelli’s approach was used to determine maximum root coverage (MRC). Restorative treatments in covering the NCCLs were limited to 1 mm apical to the calculated MRC. Modified envelope CAF was performed with full and partial thickness flap. After root exposure, root planning was done and restorative finishing was performed to acquire the ideal restorative finish line without marginal overhanging. Root surfaces were conditioned for 2 min. Adjacent interdental papillae were deepithelialized, and the flap was repositioned and secured using sling sutures to establish a tight seal, allowing the clot between the root concavity and the flap to mature. Periodontal dressing was applied. Results: After 12 days, healing was uneventful with good aesthetic and functional results. Complete root coverage according to MRC predictions was obtained, and periodontal health was normal. Conclusion: Zucchelli’s modified envelope CAF with restorative approach shows good outcomes in treating multiple gingival recessions with NCCLs, given the correct determination of MRC. Keywords: gingival recession, periodontal plastic surgery, root coverage