Case Report
Report of a case of localized chronic periodontitis treated by periodontal regenerative therapy after full mouth disinfection with antibiotics
2017 Volume 59 Issue 2 Pages 87-99
Details
2017 Volume 59 Issue 2 Pages 87-99
In this paper, we report successful treatment of a case of localized chronic progressive chronic periodontitis related to bruxism and/or some type of tooth contact habit (TCH), by periodontal regenerative therapy after full mouth disinfection with the use of antibiotics.
A 64-year-old woman visited us complaining of right upper molar gingival swelling and pain. Radiographic examination revealed wedged resorption of the upper and lower molars and furcation defects associated with conscious bruxism and TCH. A night guard was fitted, with instructions on the autosuggestion method. The initial subgingival examination revealed periodontal pathogens at high rates: Porphyromonas gingivalis, 16.16%; Tannerella forsythensis, 3.48%; and Treponema denticola, 3.68%.
Azithromycin was prescribed before full mouth disinfection (FMD) was carried out. Then, periodontal regenerative therapy was undertaken with a combination of β-tricalcium phosphate, an enamel matrix derivative, and an absorbable membrane at four sites which showed 1-2 wall intrabony defects and mandibular class II furcation defects. Compliance was obtained from the patient, because the FMD prevented the development of acute periodontal abcess. The granulation tissue and subgingival calculus which remained on the root surface were less than generally performed what would warrant scaling and rootplaning, and the operative field for periodontal regenerative therapy could be easily secured. Then, the operation time was shorter than that for usual flap operations. Clinical examination after surgery revealed improvement of the probing pocket depth, bleeding on probing and clinical attachment level. P. gingivalis, T. forsythensis and T. denticola were no longer detected, and intrabony and furcation defects appeared to have become filled in radiographs. The periodontal health of the patient has been well maintained on supportive periodontal therapy.
