Treatment Of Intrabony Defects With Gtr: A Case Report

This report describes a case of intrabony defect with class II furcation involvement (FI) of #36 with GTR. The patient was a 25-year-old woman with the chief complaint of gingival swelling in left mandibular first molar. Clinical examination showed the probing depth (PD) of the mesiobuccal of #36 is 8mm, with class II FI (lingual). Meanwhile, full-mouth bleeding score (FMBS) was 47%, full-mouth plaque score (FMPS) was 33%, and 32% of sites with the PD of ≥4 mm. Radiographic examination showed vertical bone defects with class II FI in #36. Therefore, the clinical diagnosis was generalized periodontitis (Stage III, Grade C). Initial periodontal therapy yielded an improvement with FMBS reducing to 10%, and FMPS reducing to 8%. And then, GTR was performed on #36 bone defect sites which filled with bone graft substitute (Bio-Oss, Geistlich, Switzerland), and covered with bioabsorbable membrane (Bio-Gide, Geistlich, Switzerland). The patient was seen for regular periodontal maintenance and clinical and radiographic follow-ups over 36 months. Throughout the examination periods, the PD of #36 reduced to 4 mm stably, and radiographic showed bone regeneration. Intrabony defect and class II FI are both indications for GTR. Varieties of factors including plaque control and bone defect type affect the prognosis of GTR. In this case, the patient maintained good plaque control, and GTR resulted in decreased PD and bone fill for 36-month follow-up. GTR is a good option for the treatment of infrabony defect with class II FI.