Kronik Periodontitisli Bir Hastada Kemik İçi Defektlerin Rejeneratif Tedavisi: Vaka Raporu

Hastalıklı kök yüzeylerine erişerek plak ve endotoksinler gibi lokal faktörleri uzaklaştırmak için uygulanan konvansiyonel periodontal cerrahi ile elde edilen yeni ataşman genellikle uzun bağlantı epiteli oluşumuyla sonuçlanır. Dişeti epiteli ve bağ dokusunu kök yüzeyinden uzak tutan bariyerin kullanıldığı yönlendirilmiş doku rejenerasyonu prosedürü ile kaybedilen periodontal dokuların kısmen rejenerasyonu sağlanmaktadır. Bu vaka raporunda sol alt ikinci molar bölgesinde yer alan ağrısız şişlik şikayetiyle kliniğimize başvuran 38 yaşındaki kadın hastanın rejeneratif periodontal tedavisi sunulmaktadır. Klinik ve radyografik değerlendirme sonucunda 14, 15, 16, 25 ve 37 no’lu dişler bölgesinde kemik içi defektlerin tespit edildiği hastaya kronik periodontitis teşhisi konuldu. Başlangıç periodontal tedavi sonrası kemik içi defekt bölgelerinin tedavisi için flep operasyonu ile birlikte sığır kaynaklı ksenogreft ve kolajen membran uygulandı. Yapılan 4 yıllık takip sonrasında hastalığın tekrarlamadığı ve defekt bölgelerinde kemik dolumu saptandı. Kronik periodontitisli hastalarda kemik içi defekt bölgelerine sığır kaynaklı kemik ksenogrefiyle kolajen membranın kombine kullanılmasıyla uygulanan rejeneratif periodontal tedaviyle elde edilen klinik ve radyolojik açıdan olumlu sonuçlar 4 yıl boyunca korunmuştur.

Regenerative Treatment of Intrabony Defects in a Patient with Chronic Periodontitis: Case Report

New attachment achieved by conventional periodontal surgery performed to gain access to diseased root surfaces and to remove local factors such as plaque and endotoxins, usually results in the formation of long junctional epithelium. On the contrary, guided tissue regeneration procedure in which a barrier is utilized to exclude gingival epithelium and connective tissue from the root surface, has been shown to partially regenerate lost periodontal tissues. This case report presents regenerative periodontal treatment of a 38-year old female attending with a complaint of painless swelling in the mandibular left second molar region. The patient was diagnosed as chronic periodontitis based on clinical and radiographic findings and intrabony defects were observed at teeth #14, #15, #16, #25 and #37. After initial periodontal treatment, flap operation with the principles of guided tissue regeneration was performed for treatment of intrabony defects. After 4-year follow-up period, evidence of bone fill and no sign of recurrence were seen at defect sites. It was concluded that regenerative treatment of intrabony periodontal defects by the use of bovine xenograft and collagen membrane combination provides favourable clinical and radiographic outcomes in chronic periodontitis patients and could be maintained up to 4 years successfully.

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