Effective treatment of a molar-incisor pattern periodontitis patient utilizing recombinant human platelet-derived growth factor: A case report.

Abstract

Background: Molar incisor pattern periodontitis (MIPP) poses many challenges in the field of periodontics. Emerging evidence has shown promising results in regenerative therapy while treating such a patient population. The present case study demonstrates an effective implementation of recombinant human platelet-derived growth factor (rh-PDGF) for the successful regeneration of infrabony defects associated with MIPP.

Methods: A 17-year-old African-American male patient presented to the Periodontics Clinic at Nova Southeastern University, requiring periodontal evaluation prior to the initiation of orthodontic therapy. Upon examination, the patient was diagnosed as a localized stage III, grade C MIPP. Initially, the patient underwent phase I therapy. Subsequently, surgeries consisted of regenerative procedures including a combination of allograft bone graft, rh-PDGF, and collagen membrane. The patient was seen for regular follow-ups and supportive periodontal therapy during the healing periods.

Results: The regenerative procedures resulted in significant improvement in all periodontal parameters, including probing depth, clinical attachment level, radiographic bone levels, and clinical and radiographic furcation closure, allowing the patient to retain all compromised teeth.

Conclusion: The combination of surgical debridement with rh-PDGF serves as a plausible treatment approach for infrabony defects in patients with MIPP. Further investigation through well-designed randomized controlled clinical trials is warranted to provide clearer insights.

Key point: rh-PDGF combined with an allograft is a successful treatment option in MIPP patients.

Plain language summary: Molar incisor pattern periodontitis (MIPP) is a severe form of periodontal disease, often affecting specific teeth in the periodontium of young patients. The nature of the disease requires early diagnosis and treatment to avoid potential complications, including tooth loss. This case report highlights the diagnosis and management of a patient with MIPP affecting seven teeth. Upon completion of the referral to the Periodontics Department at Nova Southeastern University, the patient was treatment planned for phase 1 therapy, including oral hygiene instructions, localized deep cleaning, and reevaluation of results in a short follow-up. Following the reevaluation appointment, the patient underwent a surgical phase via regenerative therapies utilizing bone grafts, biologics, and membranes. All surgical procedures resulted in significant improvements in clinical and radiographic parameters and remained stable over a 2-year follow-up period. This case report highlights the successful use of rh-PDGF in the treatment of MIPP-associated periodontal defects. Further investigation through well-designed clinical trials is warranted to provide clearer insights.