Dentaltown August 2021 - 43

Fig. 15: Surgical reentry procedure after five years (buccal
aspect).
Fig. 16: Surgical reentry procedure after five
years (occlusal aspect).
After suture removal, the patient was
followed up with every three months until
healing had occurred with no complications
or adverse events (Fig. 12).
Results
At the final follow-up, the CAL gain
was 9 mm and the residual PPD was
3 mm (Fig. 13).
Starting from the 12-month checkup,
the CAL was not significantly different
from that at the previous visit. Additionally,
starting from the 24-month checkup, the
mean PPD was not significantly different
from that at the previous visit, indicating
that bone resorption was absent or limited
from that time onward; indeed, as shown
in periapical radiograph, the bone defect
was completely filled (Fig. 14).
At five years from the surgery, a surgical
reentry independent of the intrabony defect
previously treated was necessary, due to a
second GBR procedure next to the intrabony
defect reported here. Such condition required
a flap opening involving the intrabony defect
and thus allowing its clinical evaluation.
Surgical reentry allowed a clinical
evaluation of the previous surgical clinical
inspection and revealed that the intrabony
defect was repaired and the aspect was that
of newly formed mature bone of the patient
(Figs. 15 and 16).
Conclusions
Many clinical studies and systematic
reviews (with meta-analyses) have shown that
the treatment of periodontal defects by
grafting bone substitutes in combination
with GTR membranes reduces PPD and
improves CAL; furthermore, they showed
that the CAL gain was maintained over
time, thus providing a high percentage of
long-term success.
In this specific case, a surgical reentry
was performed at a five-year follow-up and
clinically confirmed the reestablishment
of the lost periodontal attachment and the
complete filling of the bone defect.
Similar clinical feedback is rare in literature
and represents important clinical
evidence of the success of the intrabony
defect healing.8 n
References
1. Tarquini G. Treatment of intrabony defects using
equine-derived bone granules and collagen membranes:
A retrospective study with 13-year follow-up. Journal
of Contemporary Dental Practice, Volume 21: Issue 9
(September 2020); 970-976
2. Cortellini P, Tonetti M. Focus on intrabony defects: guided
tissue regeneration. Periodontology 2000, Vol. 22, 2000,
104-132
3. Cortellini P, Pini Prato G, Tonetti MS. The modified papilla
preservation technique with bioresorbable barrier membranes
in the treatment of intrabony defects. Case reports. Int J
Periodontics Restorative Dent 1996;16:547-559.
4.
Cortellini P, Pini Prato G, Tonetti MS. The simplified
papilla preservation flap. A novel surgical approach for the
management of soft tissues in regenerative procedures. Int J
Periodontics Restorative Dent 1999;19:589-599.
5.
Tarquini G. Guided Tissue Regeneration (GTR), Cap.
3. In: Tarquini G. " Tecniche di chirurgia parodontale:
dalla diagnosi alla terapia " (Textbook), EDRA Editions
(September 2017): 164.
6.
Tarquini G. Ultrasounds in periodontal surgery: clinical
effects. Cap. 1. In: Tarquini G. " Tecniche di chirurgia
parodontale: dalla diagnosi alla terapia " (Textbook), EDRA
Editions (September 2017): 25-26.
7. Tarquini G. Evaluation of a novel ultrasonic insert in
Guided Tissue Regeneration (GTR): a retrospective study "
Implants Italy; 1/2019: 24-28
8.
Flor├Ęs-de-Jacoby L., Zimmermann, A .,Tsalikis L.
Experiences with guided tissue regeneration in the treatment
of advanced periodontal disease. A clinical re-entry study.
Part I. Vertical, horizontal and horizontal periodontal
defects. J Clin Periodontol. 1994 Feb;21(2):113-7.
dentaltown.com \\ AUGUST 2021 43
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Dentaltown August 2021

Table of Contents for the Digital Edition of Dentaltown August 2021

Dentaltown August 2021 - Intro
Dentaltown August 2021 - Cover1
Dentaltown August 2021 - Cover2
Dentaltown August 2021 - 1
Dentaltown August 2021 - 2
Dentaltown August 2021 - 3
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Dentaltown August 2021 - 5
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Dentaltown August 2021 - Cover3
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Dentaltown August 2021 - SI_1
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