Recombinant Human Fibroblast Growth Factor (rhFGF)-2 and Autogenous Bone Graft in Periodontal Regenerative Therapy for Stage III Grade C Periodontitis: A Case Report.

Abstract

This report describes a case of periodontitis treated with periodontal surgery incorporating autogenous bone graft and recombinant human fibroblast growth factor (rhFGF) -2. The patient was a 49-year-old woman who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of swelling in the maxillary right gingiva. Tooth #37 had been extracted 12 years earlier. An initial examination revealed 33.9% of sites with a probing depth (PD) of ≥4 mm. The prevalence of sites with bleeding on probing was 35.2%. The plaque control record (PCR) score was 51.9%. Radiographic examination revealed angular bone resorption in tooth #16. Horizontal adsorption was also observed in other areas. A clinical diagnosis of generalized chronic periodontitis (Stage III Grade C) was made and periodontal therapy initiated. An improvement was observed in periodontal conditions at re-evaluation, with her PCR score decreasing to 15.7%. Periodontal surgery was performed for teeth with a residual PD ≥4 mm. Periodontal regenerative therapy using autogenous bone graft and rhFGF-2 were performed for an intrabony defect in #16. Open flap debridement was performed on #17, 35, and 36. Following evaluation, oral function was restored using a hard resin facing metal crown for #12 and CAD/CAM resin crowns for #14, 15, and 24. The patient was then placed on supportive periodontal therapy. The results showed that periodontal regenerative therapy with autogenous bone graft and rhFGF-2 yielded stable periodontal conditions, which facilitated a favorable level of plaque control.