title: Periodontal therapy for severe chronic periodontitis with periodontal regeneration and different types of prosthesis.
abstract: We report a patient with severe chronic periodontitis requiring regenerative periodontal surgery and different types of prosthesis in the maxillary and mandibular regions. The patient was a 57-year-old woman who presented with the chief complaint of occlusal pain. An initial clinical examination revealed that 73% of sites had a probing depth of ≥4 mm, and 60% of sites exhibiting bleeding on probing. Radiographic examination revealed vertical bone defects in the molar region and widening of the periodontal ligament space around teeth #17 and 24. Initial periodontal therapy was implemented based on a clinical diagnosis of severe chronic periodontitis. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using enamel matrix derivative was performed on #14, 15, and 35-37. Tunnel preparation was performed on #46 as it had a 2-wall vertical bony defect and Degree 3 furcation involvement. Other sites with residual periodontal pockets were treated by modified Widman flap surgery. After a re-evaluation, functional rehabilitation was implemented with a removable maxillary partial denture and a fixed mandibular bridge. No further deterioration was observed in the periodontal condition of most of the teeth during a 2-year period of supportive periodontal therapy (SPT). The patient is currently still undergoing SPT and some minor problems remain. However, the results suggest that treatment and subsequent maintenance for severe periodontitis with traumatic occlusion can be successful as long as the appropriate periodontal and prosthodontic treatment is planned and careful SPT carried out.
authors.affiliation: Department of Periodontology, Tokyo Dental College.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kinumatsu
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Umehara
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Nagano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
mesh_terms: D016301:Alveolar Bone Loss / Q000601:surgery; D055113:Chronic Periodontitis / Q000601:surgery*; D003746:Dental Enamel Proteins / Q000627:therapeutic use; D003769:Dental Occlusion, Traumatic / Q000628:therapy; D003773:Dental Plaque / Q000517:prevention & control; D012534:Dental Scaling / Q000379:methods; D003779:Denture Design; D003830:Denture, Partial, Fixed; D003832:Denture, Partial, Removable; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009910:Oral Hygiene / Q000193:education; D010347:Patient Care Planning; D010514:Periodontal Pocket / Q000601:surgery; D016745:Root Planing / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery
chemical_list: D003746:Dental Enamel Proteins; C109069:enamel matrix proteins