title: Localized periodontal defect associated with unusual furcation involvement on a mandibular incisor.
abstract: A localized periodontal defect associated with an unusual furcation on a mandibular central incisor and its treatment sequences are presented. A 54-year-old woman presented with a persistent localized periodontal defect, which was not responsive to nonsurgical periodontal therapy. An exploratory surgery revealed complete through and through furcation involvement on the right mandibular central incisor, resulting in a three-walled infrabony defect. Following thorough mechanical debridement and root planing, the infrabony aspect of the defect was grafted with freeze-dried bone allograft combined with the recombinant human platelet-derived growth factor-BB. The flaps were positioned to enable patient's home care and professional dental cleaning. Follow-up examination revealed uneventful healing and resolution of the infrabony periodontal defect. Clinicians should be aware of this unusual condition and consider it as a potential etiology when dealing with a persistent localized periodontal defect in the mandibular anterior sextant, which may not respond to the conventional nonsurgical periodontal therapy. Eliminating the active disease as well as enabling careful maintenance and oral hygiene may prevent further deterioration and result in a stable long-term outcome preserving the compromised tooth.
authors.affiliation: Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA. taehyun_kwon@hsdm.harvard.edu
authors.forename: TaeHyun
authors.initials: T
authors.lastname: Kwon
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Intini
authors.forename: David M
authors.initials: DM
authors.lastname: Kim
authors.forename: Liran
authors.initials: L
authors.lastname: Levin
mesh_terms: D064591:Allografts; D000077214:Becaplermin; D016025:Bone Transplantation; D003646:Debridement; D005260:Female; D017823:Furcation Defects / Q000601:surgery*; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D007180:Incisor; D008334:Mandible; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery*; D020574:Proto-Oncogene Proteins c-sis / Q000627:therapeutic use; D016745:Root Planing; D013524:Surgical Flaps
chemical_list: D020574:Proto-Oncogene Proteins c-sis; D000077214:Becaplermin