Aggressive periodontitis

Area of Science:

• Periodontology
• Oral Surgery
• Regenerative Dentistry

Background:

• Horizontally impacted mandibular molars can lead to bone loss and periodontal pockets on adjacent teeth.
• Aggressive periodontitis presents complex challenges for periodontal regeneration.
• Effective management strategies are crucial for preserving dentition.

Observation:

• A patient with generalized aggressive periodontitis and a horizontally impacted third molar presented with a deep periodontal pocket on the second molar.
• A novel 'one-stage treatment' concept was implemented, involving third molar extraction, deep scaling and root planing, and xenogenic bone grafting.
• The surgical site was fully covered with a flap, and the patient received systemic antibiotics.

Findings:

• Pre-operative probing pocket depth of 9 mm was reduced to 0-2 mm at 1, 5, and 10 years post-surgery.
• Radiographic bone levels improved from 50% to 100% after the surgical intervention.
• The one-stage treatment demonstrated sustained periodontal healing and bone regeneration over a decade.

Implications:

• This case highlights the efficacy of a comprehensive one-stage surgical and periodontal approach for managing complex aggressive periodontitis cases.
• The findings suggest that prompt and integrated treatment can lead to long-term periodontal health and bone regeneration.
• This approach offers a viable solution for patients with impacted molars and severe periodontal defects.