In the following case, periodontal regenerative surgery with amelogenins (Emdogain®) produced complete filling of two adjacent vertical, deep and non-contained defects in the lower jaw. Moreover, the results were well maintained in the long term (6 years), as demonstrated clinically and radiologically. The periodontal regenerative treatment changed the prognosis of the lower first molar in a young patient, avoiding extraction and subsequent implant placement. The strict regimen of post-surgical control visits was critical for the successful long-term maintenance of the regenerative results.
Initial situation
A systemically healthy 33-year-old patient was diagnosed with localized aggressive periodontitis. A pre-operative x-ray (Fig.1) revealed an intra-bony defect in the distal aspect of tooth #46 and on the mesial aspect of tooth #45. Following the initial preparation, a residual 10 mm periodontal pocket was evident distal to tooth #46 and a 7 mm periodontal pocket mesial to tooth #45 (Figs. 2-3).
Treatment planning
After causal therapy, the patient showed a good standard of supragingival plaque control (FMPS and FMBS<15%), and regenerative periodontal surgery with Emdogain® was scheduled.
Surgical procedure
