Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Clin Exp Dent Res. 2024 Jun;10(3):e908. doi: 10.1002/cre2.908.
Periodontitis is an inflammatory condition induced by subgingival bacterial dysbiosis, resulting in inflammatory-mediated destruction of tooth-supporting structures, potentially leading to the formation of infrabony defects. This case report describes the treatment of a patient who presented with a combination 1-2-wall defect on tooth 21. To maintain the residual periodontal attachment and minimize esthetic consequences, a regenerative approach was performed using recombinant human platelet-derived growth factor-BB (rh-PDGF-BB) and β-tricalcium phosphate (β-TCP).
At the time of postscaling/root planing reevaluation, a 34-year-old Asian male initially diagnosed with molar/incisor pattern stage III grade C periodontitis exhibited a 6-mm residual probing depth on the mesiopalatal aspect of tooth 21. Periodontal regenerative surgery was performed using rh-PDGF-BB with β-TCP, without the use of a membrane.
At the 1-year follow-up, a significant reduction in probing depth and radiographic evidence of bone fill were observed. Additionally, re-entry surgery for implant placement at site tooth 23 confirmed bone fill in the defect on tooth 21.
These results demonstrate the efficacy of rh-PDGF-BB with β-TCP in enhancing periodontal regeneration and support its use as a treatment option when treating poorly contained infrabony defects in the esthetic zone.
牙周炎是由龈下细菌失调引起的炎症性疾病,导致炎症介导的牙齿支持结构破坏,可能导致骨下缺损的形成。本病例报告描述了一名患者的治疗情况,该患者在 21 号牙上出现了 1-2 壁缺损。为了保持剩余的牙周附着,并尽量减少美观后果,采用重组人血小板衍生生长因子-BB(rh-PDGF-BB)和 β-磷酸三钙(β-TCP)进行再生治疗。
在牙周刮治/根面平整后复查时,一名 34 岁的亚洲男性最初被诊断为磨牙/切牙模式 III 级 C 期牙周炎,在 21 号牙的近中腭侧出现 6mm 的剩余探诊深度。使用 rh-PDGF-BB 和 β-TCP 进行牙周再生手术,未使用膜。
在 1 年的随访中,探诊深度显著降低,影像学显示有骨填充。此外,在 23 号牙位点进行的再手术以植入种植体证实了 21 号牙缺损处的骨填充。
这些结果表明 rh-PDGF-BB 和 β-TCP 在增强牙周再生方面的疗效,并支持在治疗美学区域内边界不良的骨下缺损时将其作为一种治疗选择。