DENTAL EDUCATION: Case of the Month – 20-Year Stability Following Regenerative Periodontal Surgery
Dr Ros O’Leary – Specialist in Periodontics, Perio & Implants, Richmond
Patient Presentation
A 45-year-old female patient was referred to Perio & Implants, Richmond, with concerns about a deep periodontal pocket around the lower left first molar (tooth 36). Despite previous non-surgical therapy, the site continued to show a persistent 9 mm probing pocket depth (PPD), bleeding on probing (BOP), and early Grade 1 mobility. The patient’s main worry was the potential loss of the tooth and the impact this would have on function.
The patient was highly motivated, demonstrated good oral hygiene, and wished to retain her natural tooth if possible.
Treatment Provided by Dr Ros O’Leary
Following full periodontal assessment and discussion of treatment options, the decision was made to proceed with regenerative periodontal surgery to restore lost attachment and stabilise the site long-term.
Surgical Approach
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Modified papilla preservation flap to access the intrabony defect
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Thorough debridement and root surface preparation
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Placement of regenerative material
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Primary closure achieved for optimal healing
The patient was enrolled in a structured supportive periodontal therapy (SPT) programme following surgery.
20-Year Clinical Outcome
The long-term results of this case are exceptional and demonstrate the value of specialist-led regenerative therapy combined with continuous maintenance care.
Findings at 20-Year Review:
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Residual pocket depth: 5–6 mm (stable since early post-operative phase)
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Bleeding on probing: None
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Mobility: None
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Radiographs: Stable bone levels, no progression of disease
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Function: Tooth remains fully functional and asymptomatic
The patient has maintained 20 years of stable periodontal health at this site — preserving a tooth that once had a poor prognosis.
Why This Case Matters
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Longevity is possible – With the right surgical approach and committed maintenance, regenerative therapy can maintain stability for decades.
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Regular maintenance is crucial – Continued supportive periodontal therapy was essential in preventing recurrence.
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Predictable outcomes – Selecting the right defects for regeneration and treating them under specialist care leads to high long-term success rates.
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Patient motivation matters – Excellent home care contributed significantly to this outstanding result.
If You Are a Patient
If you have deep gum pockets, loose teeth, or have been told you may lose a tooth, specialist regenerative periodontal treatment may be able to save it.
Contact Perio & Implants, Richmond to book a consultation with Dr Ros O’Leary.
For Referring Dentists
Dr Ros O’Leary welcomes referrals for patients presenting with:
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Persistent deep pockets
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Intrabony defects
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Progressive attachment loss
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Complex periodontal conditions
Your patients will receive specialist care and return to your practice for their routine dental treatment.
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