Advanced periodontal problems can be successfully treated with periodontal surgery. A modern approach employs microsurgical techniques combined with the application of regenerative materials. The patient above had a recurrent abscess at the 36 with advanced bone loss to the apical third of the apex. The aim of therapy was not only to resolve the acute infection, but to improve the prognosis of the tooth.
Periodontal examination revealed up to 9mm probing pocket depths at the 36 as well as a deep intrabony defect at the distal aspect. A modern minimally invasive flap design that preserved the papilla was utilized to gain access to the intrabony defect. The tooth was carefully debrided, and the root surface was treated with EDTA. Emdogain gel was then applied and a xenograft (Bio-Oss) was then used to fill the 2-3 walled defect.
The follow up at 6 months showed improved clinical parameters as well as radiographic evidence of a significant reduction of the defect. The long term prognosis of the 36 has now changed from poor to fair.
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