Gelu M ichael George, Anca Dumitriu, Horia Traian Dumitru

ADVANCED TREATMENT FOR RECURRING MARGINAL PERIODONTAL

ABSCESS. SIGNIFICANT CASE STUDY
TRATAMENT AVANSAT PENTRU REZOLVAREA DEFINITIV A ABCESULUI
PARODONTAL MARGINAL.PREZENTARE SEMNIFICATIV DE CAZ

Gelu Michael George1, Anca Dumitriu , Horia Traian Dumitru3

1
PhD, Munich, Germany
3
Prof. PhD, University of Medicine and Pharmacy "Carol Davila", Bucharest, Faculty of Dentistry, Member of the
Academy of Medical Sciences

ABSTRACT REZUMAT
Advanced bone resorption with numerous
abscesses on a frontal tooth with a high value for
recovery occlusal and prosthetic, has been resolved protetic-
despite the difficulties and reserved prognosis by a -un
complex treatment for bone regeneration. This tratament complex
regeneration was an example of a broad activity to pentru
preserve periodontal tissue of teeth with reserved
possibilities of recovery. rezervate de recuperare
Keywords: bone resorption, periodontal abscess Cuvinte cheie:
and bone regeneration

CLINICAL CASE CAZ CLINIC

Patient D.I., woman, aged 38 years, accused Pacienta D.I, 38 de ani, s-a prezentat pentru
aesthetic loss of gums at 23, with too many aspectul inestetic al gingiei al la nivelul 23
periodontal abscess in the history, treated in precum si pentru numeroase abcese parodontale
emergency procedures, so with relapses and din antecedente tratate
requesting the establishment of a
comprehensive treatment, effectively and
definitively addressed to the periodontal bone
defect involved into infection maintaining and
purulent exudates discharge. La examenul clinic obiectiv
Objective clinical examination shows: insp -
inspection of periodontal surface for 13 - gingival
retraction at a 4 mm level, absence of normal
aspect of fixed gum, "dotted gingiei fixe; la palpare, gingia sa
(stippling); probing by touch-easily bleeding adancimea de sondare cu sonda parodontala
gums, depth of probing at 16 mm (fig. 1). este de 16 mm (fig. 1).
Radiographic assessment: shows a loss of Examenul radiologic:
alveolar bone mass by mid-root and the vertical masei de os alveolar pa
bony defect on 13 at mezial (fig. 2).
Diagnosis: Chronic marginal periodontitis a lui 13.( fig 2)

64 | S o c i e t a t e a d e P a r o d o n t o l o g i e d i n R o m
 ADVANCED TREATMENT FOR RECURRING MARGINAL PERIODONTAL ABSCESS. SIGNIFICANT CASE STUDY

deep localized. Diagnostic:

In this case of advanced bone resorption,
with repeated and recurrent periodontal
abscesses usually after emergency treatment,
after examination and analysis of the situation
relevant to the morphological and clinical -
situation, an inventory of alternative treatment -
options was established:
- causal-tooth extraction, bone graft from - efe osoase cu
menton harvesting, onlay-type for defect recoltare mentoniera de tip onlay pentru
restoration refacerea defectului osos
- bone regeneration by addition -
Treatment: The treatment tried to maintain Tratament: Prin tratament s-
13 on the arch at the express wish of the patient
and, thus it was chosen to rebuild bone through -a optat astfel pentru refacerea
addition. We used Unigraft as the product t
(bioactive glass) with an intense osteogenic (
activity for bone regeneration. Am ales
We chose a more laborious treatement option,
with reduced chances of success for definitively
resolving her clinically evident suffering, e parodontale
expressed by chronic periodontal abcesses at 23. repetate la nivelul lui 23.
Work technique: After debridement of the Tehnica de lucru
bone defect, we adopted a sandwich technique
for bone addition, using Emdogain and Unigraft
after prior conditioning with Prefgel (fig. 24-28). -28).

Fig. 1. Clinical initial appearance Fig. 2. Initial radiological aspect

Fig. 3. Defect bone exposure Fig. 4. Emdogain application

Expunerea defectului osos Aplicare Emdogain

R o m a n i n J o u r n a l o f P e r i o d o n t o l o g y , v o l . 1 , i s s u e 1 , 2 0 1 0 | 65
 Gelu M ichael George, Anca Dumitriu, Horia Traian Dumitru

Fig. 5. Application of additive material (UNIGRAFT- Fig. 6. Suture wound

Unicare Biomedical)
-Unicare
Biomedical)

Fig. 7. Postoperative radiological aspects Fig. 8. Clinical appearance at 12 days

Aspect radiologic postoperator Aspect clinic la 12 zile

Fig. 9. Clinical appearance at 3 weeks Fig. 10. Clinical appearance at 5 weeks

ani ani

Fig. 11. Clinical aspect 9 months Fig. 12. X-ray appearance in 9 months
Aspect clinic la 9 luni Aspect radiologic la 9 luni

CONCLUSIONS CONCLUZII
In cases of advanced bone resorption at a -
tooth with important prosthetic restorative
value, as is a canine included in a bridge, the -o punte,dinte la

66 | S o c i e t a t e a d e P a r o d o n t o l o g i e d i n R o m
 ADVANCED TREATMENT FOR RECURRING MARGINAL PERIODONTAL ABSCESS. SIGNIFICANT CASE STUDY

tooth which clinically manifested bone damage -a manifestat

by gingival retraction and multiple periodontal
abscesses, not amenable to standard emergency parodontale care nu au cedat la tratamentul de
treatment, we chose a comprehensive surgery -

debridement and application of a sandwich -o

technique in combination with bone sandwich de asociere a unei proteine de
morphogenesis protein (Emdogain product) and
additive material glass-type fillers (Unigraft
product). Unigraft ).
Through bone regeneration, we attained a
morpho-clinical wipe-out of the infection and
prevented futher periodontal abcess recurrences a producerii de abcese parodontale recidivante
at this tooth site. la acest dinte.

R o m a n i n J o u r n a l o f P e r i o d o n t o l o g y , v o l . 1 , i s s u e 1 , 2 0 1 0 | 67