Abstract:

Background: Applying the periodontal regenerative surgical techniques improve the long-term clinical outcomes of teeth which are periodontally compromised by intrabony or inter-radicular defects. Periodontal diseases affecting the distal surfaces of multirooted teeth can be very serious problem. Different surgical techniques are proposed for treatment of infrabony defects in the distal zone of dentition. A guided tissue regeneration is a proper technique that can be used for treatment of deep intrabony defects. The success of combined technique (barrier membrane plus bone replacement graft) would lead to complete elimination of the vertical component of bone defect by bone fill and clinical attachment level gain.

Purpose: The aim of this case report is to present and analyze the healing result after regenerative periodontal therapy distally to second mandibular molar using resorbable collagen membrane and bone grafting with bovine porous bone material.

Material and methods: A vertical intrabony defect, affecting the distal surface of the second mandibular molar, is established. A combined regenerative therapy (bone graft with a barrier membrane) is used for reducing the pocket depth and achieving clinical attachment level and bone gain.

Results: The guided tissue regeneration with collagen membrane and xenograft resulted in increase of clinical attachment level of a severely compromised tooth limiting recession of the gingival margin and decrease in the periodontal pocket depth.

Conclusion: The combined regenerative therapy with barrier membrane and bone replacement graft presents satisfactory outcome results in case of severe attachment loss and loss of alveolar bone to the apical third of the root.