Periodontal Regenerative Therapy for Stage III Grade B Periodontitis with Degree 2 Furcation Involvement and Angular...

This report describes a case of generalized chronic periodontitis requiring periodontal treatment including regenerative therapy. The patient was a 50-year-old woman who visited our clinic requesting periodontal therapy. An initial examination revealed 41.6% of sites with a probing depth (PD) of ≥4 mm and 63.7% of sites with bleeding on probing. The periodontal inflamed surface area (PISA) was 1539.9 mm². Radiographic examination showed furcation involvement in #26, angular bone defect in #46, and horizontal resorption in other regions. Based on a clinical diagnosis of generalized severe chronic periodontitis (Stage III Grade B), initial periodontal therapy consisting of plaque control, and scaling and root planing was performed. Following suppression of inflammation, occlusal adjustment of cuspal interference sites was performed. After re-evaluation, periodontal surgery was performed at selected sites. Periodontal regenerative therapy was performed using autogenous bone graft for #26 and enamel matrix derivative for #46. Other sites with residual periodontal pockets were treated by open flap debridement. Following further re-evaluation, the patient was placed on supportive periodontal therapy. The patient's oral health-related quality of life showed a marked improvement after periodontal therapy. Regenerative therapy resulted in improvement in clinical parameters. Such improvement has been adequately maintained over a 7-year period. The most recent examination revealed 2.4% of sites with a PD of ≥4 mm, and the PISA was 138.2 mm². However, the furcation involvement has not been completely resolved in #26. It is necessary to continue to control inflammation and occlusion and maintain the condition of the periodontal tissue.