Abstract
Implant therapy in patients with severe periodontitis is considered to carry a high risk of postoperative complications and implant loss. We report a case of severe periodontitis in which a favorable long-term prognosis was achieved through appropriate assessment and diagnosis, periodontal intervention including tissue regeneration prior to implant therapy, and continuous maintenance.
The patient was a 40-year-old woman who visited our clinic seeking a second opinion after being advised elsewhere that 24 of her teeth required extraction. Examination revealed mobility in multiple teeth, deep periodontal pockets, and significant vertical bone resorption in addition to horizontal bone resorption. Thorough periodontal treatment was administered to save as many teeth as possible and reduce inflammation prior to implant therapy. Periodontal tissue regeneration was performed on multiple teeth during surgery, followed by orthodontic treatment and subsequent implant placement. SPT was conducted every two to three months thereafter. Although one tooth was lost due to root fracture five years into SPT, no teeth were lost due to the patient’s history of severe periodontitis, nor was there any sign of peri-implantitis. Ten years post-treatment, periodontal conditions remain improved, and good functional recovery has been maintained.
These findings suggest that in implant therapy for patients with severe periodontitis, it is essential to focus not only on clinical factors such as periodontal treatment but also on maintaining the patient’s long-term motivation for oral hygiene management. Furthermore, these results imply that implant therapy should not be viewed merely as a prosthetic replacement for missing teeth, but rather positioned as an extension of periodontal therapy.
