Triumph Over Periodontitis: A Tale of Persistence and Adaptability

Triumph Over Periodontitis: A Tale of Persistence and Adaptability

What we can achieve with perseverance in our profession 

I would like to share a case that unfolded over 20 years. It involves a 33-year-old male patient, a non-smoker, presenting with Generalised Aggressive Periodontitis (GAP), or as per the updated classification, Stage 4 Grade C periodontitis who was referred to me in 2001.

Patient at initial consultation 2001

 Our patient underwent three rounds of Root Surface Debridement (RSD) within the first five years of diagnosis. One of these courses included the administration of Amoxicillin, and subsequently, three months of Professional Mechanical Plaque Removal (PMPR). It’s important to note that this doesn’t strictly adhere to the Supportive Periodontal Care (SPC) definition, as our patient was still not periodontally stable.

The patient declined surgical intervention

Throughout treatment, surgical intervention was recommended on numerous occasions. However, the patient consistently postponed the decision, citing various personal reasons. Despite these challenges, we continued our efforts, always reminding ourselves of the importance of persistence in the face of adversity.

With time, we noticed a decrease in the depth of his gum pockets, indicating that his gum disease was being managed successfully.

The patient’s teeth numbered 35, 36, and 37 consistently demonstrated positive vitality test responses throughout the treatment period. Over time, we observed a reduction in overall Pocket Depths, indicating progress in managing his periodontitis. We also noted that tooth mobility was reduced to 1 for tooth #35, while it remained not excessive for teeth #36 and #37.

Patient follow-up 2021

Notes and Discussion

This case serves as a reminder of the importance of perseverance in our profession. Even when the circumstances seem challenging, and the path forward is uncertain, we must not give up. Monitoring tooth vitality is crucial in these cases, as it provides valuable insights into the patient’s oral health status.

In instances where surgical intervention is not possible, either due to the patient’s reluctance or other factors, it’s worthy to consider non-surgical adjuncts. These alternative approaches can help us maintain the oral health of our patients, even when conventional methods are not feasible.

To sum up, we must remember that each patient is unique, and their care requires our full dedication and flexibility. By doing this, we can ensure that we’re providing the best possible care to those who trust us with their oral health.

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