Treatment strategy for guided tissue regeneration in various class II furcation defect: Case series
A 48-year-old male patient came to the faculty of dental sciences, with a chief complain of pain and continuous discomfort in upper right posterior region of the jaw since 2 months. Patient's medical history was uneventful. On clinical examination, the palatal gingiva showed periodontal abscess and clear signs of inflammation, mobility grade-1 and 10 mm probing depth palatally and mesially to the tooth 16 []. The periapical radiograph showed a deep bony defect extending to furcation of 16 []. Electric pulp testing and thermal pulp testing were carried out to rule out endo-perio lesion. The tooth 16 showed normal response with electric and thermal pulp testing and hence no endodontic intervention was required. Therefore, considering the dental history and radiographs, a periodontal surgery was planned. After local anesthesia, a mucoperiosteal flap was raised. Severe osseous destruction was observed on palatal surface of 16 also including the mesial furcation []. Furcation involvement was class II, mesially. The palatal and mesial root surfaces were root planed. The teeth had periodontal attachment remaining on facial and distal surfaces. After thorough root planing and apical curettage, this large osseous defect, at mesial furcation was filled with the bone graft (Perio bone-G, alloplastic graft) and GTR membrane (Perio col-GTR, resorbable) covering the root surface [Figures and ]. Flap was repositioned and sutured with 3-0 silk non-resorbable interrupted sutures. Antibiotics and analgesics were prescribed for 1 week. Sutures were removed 7 days later. Patient was monitored on a weekly schedule post-operatively, to ensure good oral hygiene in the surgerized area []. Supportive periodontal maintenance at 3 months was prescribed to maintain periodontal health and to re-evaluate this area. At 11 months recall, the tooth was asymptomatic with the successful healing, mobility was absent and probing depth was minimal. The radiograph after 11 months follow-up showed evidence of apparent bone fill with resolution of the osseous defect [].