2015 Volume 58 Issue 3 Pages 241-252
Objectives: Three types of periodontal regeneration therapies are currently used in Japan: bone graft (β-Tricalcium Phosphate : β-TCP), guided tissue regeneration (GTR) method, and application of enamel matrix derivative. Here, we report a case in which favorable results were obtained using the GTR method with a bone graft for a patient with moderate chronic periodontitis whose condition was aggravated by occlusal trauma.
Case: A 58-year-old female patient was presented with the chief complaint of gingival bleeding around the maxillary right canine teeth. She was also referred to her home dentist for periodontal tissue regeneration therapy. She had a history of both dental caries and prosthetic treatment at her home dental clinic since 1975, when she was 27 years old.
The mean probing depth (PD) at the first visit to our hospital was 3.6 mm; the percentage of tooth sites with PD ≥4 mm was 43.5%; the rate of Bleeding on Probing (BOP) was 28.3%; and the O’Leary’s plaque control record was 60.8%. No inflammation was observed in the area of the marginal gingiva; however, blood stasis was observed around the maxillary anterior teeth. The overlap of the anterior teeth included an overjet of 2 mm and an overbite of 3 mm. Although horizontal bone resorption around most of the teeth was shown, the marked vertical bone resorption was around 13 and 22, and the radiolucency in the furcation area of 47 and apical area of 48 were visible on X-ray findings. After the initial therapy was completed, the area rate of PD ≥4 mm was reduced to 5.8%. Periodontal regenerative therapy was applied for the area that surrounds PD ≥4 mm around the maxillary teeth. Following periodontal surgery, we had planned to send the patient back to her home dentist. However, the patient requested comprehensive treatment at our department; therefore, we consulted her home dentist and revised the treatment plan.
The improvement of the patient’s clinical parameters is currently stable; however, the site of PD 5 mm without BOP still remained in the center of 47. Therefore, we are continuing supportive periodontal therapy for the patient.
Conclusion: In this case, we performed the GTR method accompanied by a bone graft for severe vertical bone loss. The periodontal tissue condition has remained stable for 6 years after surgery.
