(R-08) A Case Report of a Patient with Severe Chronic Periodontitis and Early Occlusal Breakdown Treated with Periodontal Regeneration and Implant Therapy.

Background:
This is a case report of a patient with severe chronic periodontitis and early occlusal breakdown that was successfully treated with periodontal regeneration and implant therapy,

Case:
A 68-year-old female visited our dental office in May 2014 with a chief complaint of a poor response to initial periodontal treatment. The patient was a non-smoker and had been taking Fosamax® (alendronate sodium) for 10 years for osteoporosis. The Plaque Control Record (PCR) at the initial visit was 84%. Teeth #14, #15, and #18 had Class 3 mobility. Teeth #3 and #18 had Class I and Class II furcation involvement. The occlusal relationship was Skeletal Class II with Angle class II. Occlusal interferences were noted on teeth #15 and #18. The patient was diagnosed with Generalized Periodontitis Stage III Grade C.
Clinical Procedures and Outcomes:
Following initial treatment, a re-evaluation was performed. Fosamax was discontinued prior to the surgical phase, and periodontal regeneration was performed for teeth #3, #18, and #19. A dental implant was placed at site #30. Teeth #14 and #15 were extracted and GBR was performed, followed by implant placement. After occlusal function was restored, a re-evaluation was completed and the patient was transitioned to SPT (supportive periodontal therapy). The PCR score continually decreased and the periodontal condition stabilized. The patient has been in SPT for 6 years and the periodontal condition remains stable.

Conclusion:
Further occlusal breakdown was prevented through periodontal regeneration and implant therapy, which allowed for occlusal stabilization. It could be suggested that long-term stability will remain with continued SPT.