This week in regeneration….
This week’s episode is ” A very special one “… ( are November sweeps upon us already? Will Fonzie Jump over the shark? Will House end up with Cuddy?).
Actually, this case is interesting as it helps us to understand the potential for treating otherwise difficult periodontal defects and enable patients to retain their own teeth rather than extract and place fixtures. That said, fixtures are terrific, but in the esthetic zone there are significant hurdles to overcome, so why not work with what we have, when we can.
pre-op..Jan 2006-note the discrepancy of the
incisal edges 8-9
14 mm probing depth
13 mm horizontal defect
This fellow, at the time was 35 and a smoker. He presented with a defect on the mesial of #8. At first blush, it didnt seem that anything was wrong- but probing and radiographs proved otherwise. To treat a defect of this nature, one with both a vertical and horizontal component in this area, is always a challenge. By elevating the tissue alone to place a graft/membrane you will be left with recession and the dreaded “black triangle”.
Immediate Post-op- pre incisal adjustment
The case was treated with LPT ( LANAP ) and the results were excellent , if not curious…. The radiograph at the end shows the pre-op lesion and on the left- 4 yr post-op…. note the incisive canal as a landmark for the re-growth of the interproximal bone.
1 yr post-op
4 year post-op ( slight triangle )
4 yr post-op p.a. pre-op showing extent of defect.
n.b. – the foramen as a landmark for bone-regrowth
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