Comprehensive periodontal treatment, including regenerative therapy and osseointegrated implants, was performed in a patient with aggressive periodontitis. A 36-year-old woman with severe general bone loss and no diagnosable medical disease was referred to our hospital for gingival pain and swelling in bilateral mandibular molar regions. Intraoral findings showed generalized inflamed gingiva and plaque deposits. No other risk factors, other than plaque, were observed in this patient. After initial periodontal therapy, we conducted surgical treatments including regenerative therapies using Enamel matrix derivative (Emdogain), guided tissue regeneration, and osseointegrated implant surgery with guided bone regeneration. After treatment, the patient' s gingival bleeding, plaque score and probing pocket depth improved. The regenerative therapies enabled a gain in attachments, and osseointegrated implants in the right mandibular molar regions improved occlusal function. Esthetic concerns were alleviated by edentulous ridge augmentation with subepithelial connective tissue grafts on the upper anterior regions. These multi-disciplinary treatment modalities was useful for the treatment of patients with aggressive periodontitis. J Jpn Soc Periodontol, 45: 95-104, 2003.
The Japanese Society of Periodontology