Three-year follow-up of periodontal regenerative therapy for multiple severe intrabony defects: A case report.

Background: The effectiveness of periodontal regenerative therapy has been well-documented in the literature, with various factors influencing treatment outcomes. This case report illustrates the successful management of a systemically healthy patient diagnosed with Generalized Stage III Grade C periodontitis through the application of periodontal regenerative therapy.

Methods: Following nonsurgical periodontal therapy, including oral hygiene instructions and scaling and root planing, the patient underwent full-mouth regenerative treatment secondary to persistent deep probing depths (PDs), radiographic evidence of intrabony defects (primarily 1- to 2-wall defects), and degree II furcation defects associated with the maxillary first molars. Treatment consisted of a combination of bone grafts, biologics, and absorbable barrier membranes utilized to maximize the regeneration of alveolar bone, periodontal ligament, and cementum.

Results: At the 6-month follow-up, significant improvements relative to reductions in PDs, gains in clinical attachment levels, minimal bleeding on probing, and radiographic bone fill were observed. Additionally, the prognosis of affected teeth improved, and the risk of disease progression was reduced. These outcomes have been well maintained for 3 years with appropriate supportive periodontal treatment.

Conclusions: Within the parameters of this single case report, we can propose that there is the possibility that periodontal defects with a potentially poor regenerative likelihood can be successfully managed with regenerative therapy utilizing open flap debridement, bone grafts, biologic mediators, and barrier membranes. It is noteworthy that careful consideration and management of factors influencing the outcomes of periodontal regenerative therapy are crucial for treatment success.

Key points: Severe periodontal defects with limited regenerative potential can be successfully treated with periodontal regenerative therapy using the combination approach. Periodontal regenerative therapy can improve tooth prognosis and reduce a patient's overall periodontal risk. Careful management of etiology and risk factors, along with patient compliance with periodontal maintenance, are critical to achieving favorable treatment outcomes.

Plain language summary: This case report presents medium-term outcomes of periodontal regenerative therapy aimed at restoring tooth-supporting structures lost to periodontal disease. A combination approach using bone grafts, biologic mediators, and barrier membranes can effectively treat multiple periodontal defects with limited regenerative potential, thereby restoring periodontal health. The therapy improved tooth prognosis and reduced the patient's risk of future periodontal disease progression. Treatment success depends on various factors, including proper management of etiologic and risk factors, as well as patient compliance with periodontal maintenance protocols.