Full Mouth Rehabilitation of Localized Aggressive Periodontitis: A Case Report of 36 Months Follow-Up

Case Presentation

J Dent App. 2016; 3(4): 361-364.

Full Mouth Rehabilitation of Localized Aggressive Periodontitis: A Case Report of 36 Months Follow-Up

Polepalle T¹, Chaitanya A¹, Firoz Babu P², Boggarapu S¹ and Nayyar AS³*

¹Department of Periodontics and Implantology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India

²Department of Orthodontics and Dentofacial Orthopedics, Rama Dental College and Hospital, Kanpur, Uttar Pradesh, India

³Department of Oral Medicine and Radiology, Saraswati- Dhanwantari Dental College and Hospital and Post- Graduate Research Institute, Parbhani, Maharashtra, India

*Corresponding author: Abhishek Singh Nayyar, 44, Behind Singla Nursing Home, New Friends’ Colony, Zodel Town, Panipat-132 103, Haryana, India

Received: December 02, 2016; Accepted: December 29, 2016; Published: December 30, 2016


Localized Aggressive Periodontitis is characterized by deep vertical osseous defects that affect molars and incisors. This case report is of a 35 years male patient diagnosed with localized aggressive periodontitis with intrabony defects. Regeneration of intra-bony defects was carried-out with use of composite grafts [(FDBA, Biograft HA, Osseograft, Sybograft, Autogenous graft) + Gengigel]. After 6 months, all grafts showed radiographic bone fill but at 36 months, FDBA, Osseograft along with Gengigel showed better radiographic bone fill than the other composite grafts. Buccal bone augmentation was done in 12 regions to receive prosthesis. Thus, full mouth rehabilitation was achieved.

Keywords: Localized Aggressive Periodontitis; Regeneration; Bone grafts; Buccal ridge augmentation


Regeneration of lost tissues to its pre-disease state is the desired goal for clinicians in periodontitis. Various procedures like open flap debridement alone or, combined with bone grafts and GTR are employed to accomplish the ultimate goal of periodontal therapy [1]. Autogenous graft is an ideal graft material for regeneration but its major disadvantage is that it requires a second surgical site to procure the graft tissue [2]. FDBA is a mineralized bone graft which promotes regeneration by osteoconduction and is suitable for space maintenance [3]. Xenografts are the alternatives but because of the risk of immunogenic reactions and rejection by host tissue, they are not as successful as autografts [4]. Alloplastic materials are used as fillers and as scaffolds and are biocompatible. BioGraft HA is a composite bioactive material for periodontal osseous defect reconstructions and regeneration. The particle size of Biograft HA is 150-700 μ with an internal pore size of 100-200 μ, used specifically, for periodontal applications [5]. Nano-crystalline hydroxyapatite (NcHA) bone graft was introduced commercially as Sybograft. The advantages are osteoconductivity, bioresorbability and the presence of high number of molecules on the surface [6]. Hyaluronic acid (hyaluronan) is a widely distributed glycosaminoglycan in the extracellular matrix of mammalian connective tissues. Gengigel contains Hyaluronic acid in 0.8% concentration in gel formulation and is suitable for bone regeneration [7]. In the present case report, we tried to explore the beneficial effects of composite grafts [(FDBA, Biograft HA, Osseograft, Sybograft, Autogenous graft) + Gengigel] in intra-bony osseous defects.

Case Presentation

A 35 years old male patient reported with the chief complaint of deposits on teeth. On clinical examination, patient was diagnosed with localized aggressive periodontitis based on the clinical and radiographic features. Clinical parameters were recorded pre- operatively and after 6, 12, 24 and 36 months by a trained examiner. The pocket probing depth (PD) and clinical attachment level (CAL) were recorded to the nearest millimeter with a UNC-15 probe (Hu- Friedy probe) at the deepest point of the periodontal pocket. In radiographic examination, an orthopantomograph (OPG) was used to evaluate the radiographic level of bone wherein deep intra-bony defects were observed in the molar and incisal regions (Figure 1 and 2).