Saving the questionnaire periodontally compromised teeth in the aesthetic zone: a case report
Introduction: The persistence of bleeding periodontal pockets that associated with intra-bony defects (IBD) increases the risk of tooth loss and is considered a clinical challenge. The prognosis of such teeth with grade II mobility and severe attachment loss (AL) is questionable according to McGuir...
| Main Authors: | , |
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| Format: | Conference or Workshop Item |
| Language: | English |
| Published: |
2014
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/37995/ http://irep.iium.edu.my/37995/1/Binder1.pdf |
| Summary: | Introduction:
The persistence of bleeding periodontal pockets that associated with intra-bony defects (IBD) increases the risk of tooth loss and is considered a clinical challenge. The prognosis of such teeth with grade II mobility and severe attachment loss (AL) is questionable according to McGuire 1991. Nevertheless proper periodontal treatment (PT) and supportive periodontal care might retain the periodontally compromised teeth.
Case reports:
A 35-year-old female with aggressive periodontitis was referred to the periodontics specialist clinic of IIUM. The full periodontal chart revealed grade II mobility of the upper central incisors (UCI) and pus discharge with deep propping depths and severe AL. The rapid rate of bone destruction affected the sites of the first and second molars as well. A combination of oral metronidazole and amoxicillin were prescribed for 7 days. Six weeks after the nonsurgical PT, the affected sites were reevaluated, and a decision of regenerative therapy was scheduled for the circumferential bone defects around the UCI. A papilla preservation technique was applied with bovine xenograft and resorbable barrier membrane. Splinting of the anterior teeth stabilized the wound healing, and a thorough professional and self-plaque control maintained a good oral hygiene post-surgical treatment. A significant probing reduction and attachment gain was achieved (PD: 8 mm at base line to 2 mm post treatment and maintained at 1 year).
Comments:
With proper flap design and regenerative treatment, deep IBD to the apex would not be an option for the extraction. The aggressive bone destruction as observed in CBCT was managed successfully.
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