Comprehensive Periodontal Treatment for a Patient with Aggressive Periodontitis

Comprehensive periodontal treatment, including regenerative therapy and osseointegrated implants, was performed in a patient with aggressive periodontitis. A 36-year-old woman with severe general bone loss and no diagnosable medical disease was referred to our hospital for gingival pain and swelling...

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Published inNihon Shishubyo Gakkai Kaishi (Journal of the Japanese Society of Periodontology) Vol. 45; no. 1; pp. 95 - 104
Main Authors Shin, Kitetsu, Takahashi, Keiso, Yasui, Toshikazu
Format Journal Article
LanguageJapanese
Published JAPANESE SOCIETY OF PERIODONTOLOGY 2003
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ISSN0385-0110
1880-408X
DOI10.2329/perio.45.95

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Abstract Comprehensive periodontal treatment, including regenerative therapy and osseointegrated implants, was performed in a patient with aggressive periodontitis. A 36-year-old woman with severe general bone loss and no diagnosable medical disease was referred to our hospital for gingival pain and swelling in bilateral mandibular molar regions. Intraoral findings showed generalized inflamed gingiva and plaque deposits. No other risk factors, other than plaque, were observed in this patient. After initial periodontal therapy, we conducted surgical treatments including regenerative therapies using Enamel matrix derivative (Emdogain), guided tissue regeneration, and osseointegrated implant surgery with guided bone regeneration. After treatment, the patient' s gingival bleeding, plaque score and probing pocket depth improved. The regenerative therapies enabled a gain in attachments, and osseointegrated implants in the right mandibular molar regions improved occlusal function. Esthetic concerns were alleviated by edentulous ridge augmentation with subepithelial connective tissue grafts on the upper anterior regions. These multi-disciplinary treatment modalities was useful for the treatment of patients with aggressive periodontitis. J Jpn Soc Periodontol, 45: 95-104, 2003.
AbstractList Comprehensive periodontal treatment, including regenerative therapy and osseointegrated implants, was performed in a patient with aggressive periodontitis. A 36-year-old woman with severe general bone loss and no diagnosable medical disease was referred to our hospital for gingival pain and swelling in bilateral mandibular molar regions. Intraoral findings showed generalized inflamed gingiva and plaque deposits. No other risk factors, other than plaque, were observed in this patient. After initial periodontal therapy, we conducted surgical treatments including regenerative therapies using Enamel matrix derivative (Emdogain), guided tissue regeneration, and osseointegrated implant surgery with guided bone regeneration. After treatment, the patient' s gingival bleeding, plaque score and probing pocket depth improved. The regenerative therapies enabled a gain in attachments, and osseointegrated implants in the right mandibular molar regions improved occlusal function. Esthetic concerns were alleviated by edentulous ridge augmentation with subepithelial connective tissue grafts on the upper anterior regions. These multi-disciplinary treatment modalities was useful for the treatment of patients with aggressive periodontitis. J Jpn Soc Periodontol, 45: 95-104, 2003.
Author Takahashi, Keiso
Shin, Kitetsu
Yasui, Toshikazu
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References 高橋慶壮: 5章歯周疾患のリスク因子-特に遺伝因子および環境因子- 歯周病と骨の科学骨代謝からインプラントまで, p41-64, 宮田隆, 辰巳順一, 医歯薬出版株式会社, 東京, 2002.
Takahashi K, Ohyama H, Kitanaka M, Sawa T, Mineshiba J, Nishimura F, Arai H, Takashiba S, Murayama Y: Heterogeneity of host immunological risk factulb in patients with aggressive periodontitis. J Periodontol, 72: 425-437, 2001.
Nishida H, Takahashi K, Takeda II, Azuma T, Motohira K, Shin K, Miyata T: Telomere Length as a Novel Risk Marker for Early-Onset Periodontitis. J Dent Res, 80: special issue, 1612, 2001.
Saito A, Hosaka Y, Nakagawa T, Seida K, Yamada S, Okuda K. Locally delivered minocycline and guided tissue regeneration to treat postjuvenile periodontitis. A case report. J Periodontol, 65: 835-839, 1994.
Dahlin C, Gottlow J, Linde A, Nyman S: Healing of maxillary and mandibular bone defects using a membrane technique. An experimental study in monkeys. Scand J Plast Reconstr Surg Hand Surg, 24: 13-19, 1990.
Buser D, Dula K, Hirt H, Berthold H: Localized ridge augmentation using guided bone regeneration. In: Buser D, Dahlin C, Schenk RK (eds) Guided bone regeneration in implant dentistry. St Louis: Midwest technical publications, 189-233, 1994.
Windisch P, Sculean A, Klein F, Toth V, Gera I, Reich E, Eickholz P: Comparison of clinical, radiographic, and histometric measurements following treatment with guided tissue regeneration or enamel matrix proteins in human periodontal defects. J Periodontol, 73: 409-417, 2002.
Wennstrom A, Wennstrom J, Lindhe J: Healing following surgical and non-surgical treatment of juvenile periodontitis. A 5-year longitudinal study. J Clin Periodontol, 13: 869-882, 1986.
Mombelli A: Microbiology and antimicrobial therapy of peri-implantitis. Periodontol 2000, 28: 177-189, 2002.
Palmer RM, Watts TL, Wilson RF: A doubleblind trial of tetracycline in the management of early onset periodontitis. J Clin Periodontol, 23: 670-674, 1996.
Heijl L, Heden G, Svardstrom G, Ostgren A: Enamel matrix derivative (EMDOGAIN) in the treatment of intrabony periodontal defects. J Clin Periodontol, 24: 705-714, 1997.
Quirynen M, Peeters W, Naert I, Coucke W, van Steenberghe D: Peri-implant health around screw-shaped c. p. titanium machined implants in partially edentulous patients with or without ongoing periodontitis. Clin Oral Implants Res, 12: 589-594, 2001.
Heden G, Wennstrom J, Lindhe J: Periodontal tissue alterations following Emdogain treatment of periodontal sites with angular bone defects. A series of case reports. J Clin Periodontol, 26: 855-860, 1999.
Quirynen M, De Soete M, van Steenberghe D: Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res, 13: 1-19, 2002.
Yang J, Lee HM, Vernino A: Ridge preservation of dentition with severe periodontitis. Compend Contin Educ Dent, 21: 579-583, 2000.
Novak MJ, Stamatelakys C, Adair SM: Resolution of early lesions of juvenile periodontitis with tetracycline therapy alone: long-term observations of 4 cases. J Periodontol, 62: 628-633, 1991.
Takahashi K, Takeda H, Motohira K, Shin K, Miyata T: Aggressive Periodontitis Associated with Palmoplantar Pustulos. J Dent Res 80: special issue, 579, 2001.
Saxen L, Asikainen S, Sandholm L, Kari K: Treatment of juvenile periodontitis without antibiotics. A follow-up study. J Clin Periodontol, 13: 714-719, 1986.
Dahlin C, Linde A, Gottlow J, Nyman S: Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg, 81: 672-676, 1988.
Mengel R, Stelzel M, Hasse C, Flores-de-Jacoby L: Osseointegrated implants in patients treated for generalized severe adult periodontitis. An interim report. J Periodontol, 67: 782-787, 1996.
佐藤直志: chapter5GBRによる骨の再生In: 歯周外科の臨床とテクニックp248-333, クインテッセンス出版株式会社, 東京, 1997.
Buser D, Dula K, Hirt HP, Berthold H: Guided bone regeneration in dehiscence defects and delayed extraction sockets. In: Guided Bone Regeneration in Implant Dentistry. Edited by Buser D, Darlin C, Schenk RK. Chicago, Quintessence: p 155-188, 1994.
Kim KJ, Kim DK, Chung CP, Son S: Longitudinal monitoring for disease progression of localized juvenile periodontitis. J Periodontol, 63: 806-811, 1992.
Nevins ML, Gartner-Sekler JL: Periodontal, implant, and prosthetic treatment for advanced periodontal disease. Compend Contin Educ Dent, 18: 469-74, 476, 478-479, 1997.
Sirirat M, Kasetsuwan J, Jeffcoat MK: Comparison between 2 surgical techniques for the treatment of early-onset periodontitis. J Periodontol, 67: 603-607, 1996.
Pontoriero R, Wennstrom J, Lindhe J: The use of barrier membranes and enamel matrix proteins in the treatment of angular bone defects. A prospective controlled clinical study. J Clin Periodontol, 26: 833-840, 1999
References_xml – reference: Takahashi K, Ohyama H, Kitanaka M, Sawa T, Mineshiba J, Nishimura F, Arai H, Takashiba S, Murayama Y: Heterogeneity of host immunological risk factulb in patients with aggressive periodontitis. J Periodontol, 72: 425-437, 2001.
– reference: Dahlin C, Gottlow J, Linde A, Nyman S: Healing of maxillary and mandibular bone defects using a membrane technique. An experimental study in monkeys. Scand J Plast Reconstr Surg Hand Surg, 24: 13-19, 1990.
– reference: Mengel R, Stelzel M, Hasse C, Flores-de-Jacoby L: Osseointegrated implants in patients treated for generalized severe adult periodontitis. An interim report. J Periodontol, 67: 782-787, 1996.
– reference: Yang J, Lee HM, Vernino A: Ridge preservation of dentition with severe periodontitis. Compend Contin Educ Dent, 21: 579-583, 2000.
– reference: Sirirat M, Kasetsuwan J, Jeffcoat MK: Comparison between 2 surgical techniques for the treatment of early-onset periodontitis. J Periodontol, 67: 603-607, 1996.
– reference: Mombelli A: Microbiology and antimicrobial therapy of peri-implantitis. Periodontol 2000, 28: 177-189, 2002.
– reference: Dahlin C, Linde A, Gottlow J, Nyman S: Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg, 81: 672-676, 1988.
– reference: Saxen L, Asikainen S, Sandholm L, Kari K: Treatment of juvenile periodontitis without antibiotics. A follow-up study. J Clin Periodontol, 13: 714-719, 1986.
– reference: Saito A, Hosaka Y, Nakagawa T, Seida K, Yamada S, Okuda K. Locally delivered minocycline and guided tissue regeneration to treat postjuvenile periodontitis. A case report. J Periodontol, 65: 835-839, 1994.
– reference: Kim KJ, Kim DK, Chung CP, Son S: Longitudinal monitoring for disease progression of localized juvenile periodontitis. J Periodontol, 63: 806-811, 1992.
– reference: Quirynen M, De Soete M, van Steenberghe D: Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res, 13: 1-19, 2002.
– reference: Buser D, Dula K, Hirt H, Berthold H: Localized ridge augmentation using guided bone regeneration. In: Buser D, Dahlin C, Schenk RK (eds) Guided bone regeneration in implant dentistry. St Louis: Midwest technical publications, 189-233, 1994.
– reference: Heden G, Wennstrom J, Lindhe J: Periodontal tissue alterations following Emdogain treatment of periodontal sites with angular bone defects. A series of case reports. J Clin Periodontol, 26: 855-860, 1999.
– reference: Wennstrom A, Wennstrom J, Lindhe J: Healing following surgical and non-surgical treatment of juvenile periodontitis. A 5-year longitudinal study. J Clin Periodontol, 13: 869-882, 1986.
– reference: Palmer RM, Watts TL, Wilson RF: A doubleblind trial of tetracycline in the management of early onset periodontitis. J Clin Periodontol, 23: 670-674, 1996.
– reference: 高橋慶壮: 5章歯周疾患のリスク因子-特に遺伝因子および環境因子- 歯周病と骨の科学骨代謝からインプラントまで, p41-64, 宮田隆, 辰巳順一, 医歯薬出版株式会社, 東京, 2002.
– reference: Windisch P, Sculean A, Klein F, Toth V, Gera I, Reich E, Eickholz P: Comparison of clinical, radiographic, and histometric measurements following treatment with guided tissue regeneration or enamel matrix proteins in human periodontal defects. J Periodontol, 73: 409-417, 2002.
– reference: Nishida H, Takahashi K, Takeda II, Azuma T, Motohira K, Shin K, Miyata T: Telomere Length as a Novel Risk Marker for Early-Onset Periodontitis. J Dent Res, 80: special issue, 1612, 2001.
– reference: Nevins ML, Gartner-Sekler JL: Periodontal, implant, and prosthetic treatment for advanced periodontal disease. Compend Contin Educ Dent, 18: 469-74, 476, 478-479, 1997.
– reference: Heijl L, Heden G, Svardstrom G, Ostgren A: Enamel matrix derivative (EMDOGAIN) in the treatment of intrabony periodontal defects. J Clin Periodontol, 24: 705-714, 1997.
– reference: Takahashi K, Takeda H, Motohira K, Shin K, Miyata T: Aggressive Periodontitis Associated with Palmoplantar Pustulos. J Dent Res 80: special issue, 579, 2001.
– reference: Quirynen M, Peeters W, Naert I, Coucke W, van Steenberghe D: Peri-implant health around screw-shaped c. p. titanium machined implants in partially edentulous patients with or without ongoing periodontitis. Clin Oral Implants Res, 12: 589-594, 2001.
– reference: Pontoriero R, Wennstrom J, Lindhe J: The use of barrier membranes and enamel matrix proteins in the treatment of angular bone defects. A prospective controlled clinical study. J Clin Periodontol, 26: 833-840, 1999
– reference: Buser D, Dula K, Hirt HP, Berthold H: Guided bone regeneration in dehiscence defects and delayed extraction sockets. In: Guided Bone Regeneration in Implant Dentistry. Edited by Buser D, Darlin C, Schenk RK. Chicago, Quintessence: p 155-188, 1994.
– reference: 佐藤直志: chapter5GBRによる骨の再生In: 歯周外科の臨床とテクニックp248-333, クインテッセンス出版株式会社, 東京, 1997.
– reference: Novak MJ, Stamatelakys C, Adair SM: Resolution of early lesions of juvenile periodontitis with tetracycline therapy alone: long-term observations of 4 cases. J Periodontol, 62: 628-633, 1991.
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Snippet Comprehensive periodontal treatment, including regenerative therapy and osseointegrated implants, was performed in a patient with aggressive periodontitis. A...
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SubjectTerms aggressive periodontitis
comprehensive periodontal treatment
osseointegrated implant
regenerative therapy
Title Comprehensive Periodontal Treatment for a Patient with Aggressive Periodontitis
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