DENTAL EDUCATION:
Case Overview
Clinician: Dr Bruno Delaunay
Duration: Nov 2024 – Sept 2025
Patient Profile: 58-year-old male, no relevant medical history
The patient was referred after a year of non-surgical periodontal therapy (NST) on the lower right first molar (LR6). While pocket depths had improved, the distal pocket remained at 7mm. Given the persistence of disease activity, regenerative periodontal surgery was considered.
Treatment Strategy
- Diagnosis
- Localised Stage IV, Grade C periodontitis – unstable
- Baseline probing: 7mm distal LR6 (14/11/24)
- Initial Therapy
- One round of non-surgical therapy (scaling and root surface debridement)
- Reassessment after 2 months (23/01/25): no improvement – pocket remained at 7mm
- Corrective Therapy – Regenerative Surgery
- Date: 06/03/25
- Surgical approach: flap access with regenerative procedure
- Graft/biomaterials: Bio-Oss® with Emdogain®
- Defect morphology: 3-wall contained defect – favourable for regeneration
- Rationale: aimed to restore periodontal support and stabilise the tooth
- Supportive Care
- 2-month review: reinforcement of daily plaque control and oral hygiene instruction
- Close monitoring for healing and compliance
Clinical Outcome at 6 Months
At reassessment in Sept 2025:
- Probing depth: reduced to 3mm distal LR6
- Bleeding on probing: absent
- Radiograph: evidence of bone fill in the defect
- Symptoms: no pain, no sensitivity
- Patient feedback: very satisfied with the outcome
Takeaways
This case highlights:
- Importance of referral: timely recognition of sites unresponsive to NST can prevent further progression.
- Defect morphology matters: contained 3-wall defects provide highly favourable conditions for regenerative success.
- Predictable regeneration: biomaterials like Bio-Oss® and Emdogain® can restore stability and function in advanced localised defects.
- Patient-centred success: reduced probing depth, absence of bleeding, and symptom-free healing led to high patient satisfaction.
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