Treatment of Stage III Grade C Periodontitis with Periodontal Regenerative Therapy including Guided Tissue Regeneration (GTR) and Recombinant Human Fibroblast Growth Factor (rhFGF)-2: A Case Report.

Abstract

This report describes a case of periodontitis treated with periodontal surgery including guided tissue regeneration (GTR) and recombinant human fibroblast growth factor (rhFGF)-2. The patient was a 54-year-old woman who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of swelling in the maxillary right gingiva. An initial examination revealed 30.4% of sites with a probing depth (PD) of ≥4 mm. The prevalence of sites with bleeding on probing was 57.7%. The plaque control record (PCR) score was 66.1%. Radiographic examination revealed vertical bone defects in the molar region. Based on these findings, the clinical diagnosis was generalized chronic periodontitis (Stage III, Grade C). Initial periodontal therapy yielded an improvement in periodontal conditions, with the PCR score reducing to 13.8%. Periodontal surgery was performed for teeth with a residual PD ≥4 mm. Guided tissue regeneration was performed on #37 and 47. A series of periodontal regenerative treatments comprising application of rhFGF-2 was performed on angular bone defects in #14, 15, 25, and 27. Open flap debridement was performed on #16, 17, 26, 36, and 46. Following evaluation, oral function was restored by placing all-ceramic crowns on #21 and 26. The patient was then placed on supportive periodontal therapy. In the present case of generalized chronic periodontitis, periodontal regenerative therapy with GTR and rhFGF-2 yielded stable periodontal conditions.