Guided Gum Tissue Regeneration
54 y.o. female in excellent overall health. She presented for a full mouth evaluation in 5/10 and was diagnosed with Advanced Periodontitis. Moreover, she had a fistula that traced back to the furcation on #31. The tooth had a 2+ mobility and was painful upon percussion. The tooth was not pulp tested but the pt was referred back to endo to have the case evaluated/ treated prior to LANAP. Despite the apices not being involved there is a significant chance that an accessory canal through the exposed furcation would render the tooth non-vital, and having the endo performed first is preferable. The pt declined as she was leaning towards extraction of the tooth and replacement with a fixture.
The LANAP was performed in 6/10 and this tooth was slated for probable removal sometime thereafter.
Upon re-eval yesterday- There was no appreciable mobility ( n.b.- occlusal adjustment was performed), no sign of a fistula, no pain to percussion and most interesting was the periapical radiograph which shows clear fill on the furcation and on the mesial aspect of the crater. Studies show that it could take up to 24 months for GTR to work- this one is seems to be healing within a much shorter time frame. It remains to be seen whether or not it will continue to fill in, but for the moment we will leave it alone. The patient is comfortable and happy. It is moving in the right direction, for now…
My question to you is :
Does anyone have any similar experiences with LANAP where the case healed without the need for endodontic intervention? Or- should we expect some breakdown ( and when) which will put us back into the discussion for further tx of this tooth?
Does anyone have experience with traditional therapy where they have seen a similar result ( i.e- where guided tissue regeneration was performed but no endo)? And how long did it take for the area to “fill in?”