The comprehensive periodontal, resorative end prosthodontic therapy of chronic periodontitis

Abstract

Chronic periodontitis predictable responds to mechanical cleaning and cause related periodontal surgery. Nowadays the
therapeutic protocol of the chronic periodontitis is widely known and scientifically proven. The therapy can be split into
two major phases, the inicial or cause related therapy and the surgical therapy, however in the most of the cases the patients
need complex periodontal, restorative and prosthodontic therapy. The presented case demonstrates the process
and results of the complex treatment of a 55 years old patient suffering from chronic periodontitis. The patient didn’t have
hopeless teeth. In the first phase of the cause related periodontal therapy professional oral hygiene treatment, scaling
rootplaning and subgingival curettage were performed by quadrants. At the re-evaluation after the conservative periodontal
therapy there was a significant pocket reduction in the mandibular quadrants, however there was a need for surgical
pocket therapy in the molar regions of the maxillary quadrants. Modified Widman-flap surgery and osteoplasty were performed
in both of the maxillary quadrants. After the surgical periodontal therapy the revision of the old root canal fillings
was accomplished in the teeth 24, 36 and 47. Due to an inflammatory root resorption, root resection was performed following
the root canal filling on the tooth 24. Three months after the root resection surgery, the tooth was reinforced by a
glass fiber post. Nine months postoperatively the periapical area of the tooth 24 showed growing radioopacity After the
second reevaluation of patient’s compliance and the healing tendencies full mouth prosthodontic reheabilitation was provided.
Metalloceramic crowns with a supragingival margin were made on the teeth 12, 24 and 36, metalloceramic bridge
was made on the teeth 44 and 47. After the periodontal, restorative and prosthodontic therapy were finished the patient
was remanded every 3 months for periodontal supportive therapy and could maintain excellent oral hygiene with a plaque
score under 20% and a bleeding score of 6%.