Periodontics · patient case question
A 6 mm infrabony defect is found distal to tooth #7, which is vital with no history of trauma and no vertical fracture. Which treatment is most effective?
Patient case: Advanced Periodontitis
demo: 48-year-old male
chief: “My teeth are moving and I have gaps that were never there.”
history: Type 2 diabetes, HbA1c 8.4%. Smokes 15 cigarettes per day.
meds: Metformin
findings: Probing depths 7–10 mm generalized. Interdental clinical attachment loss extending beyond the middle third of the root at more than five teeth. Class II furcations at #3 and #14, tooth mobility degree 2, pathologic migration with flaring of the maxillary incisors, 18 remaining teeth. Radiographic bone loss has advanced 3 mm in the last 4 years.
Show answer and explanation
Correct answer: A. Guided tissue regeneration
- A. Correct. A narrow, contained vertical (infrabony) defect is the classic indication for GTR. A barrier membrane excludes epithelium and gingival connective tissue so that PDL and bone cells repopulate the defect.
- B. Gingivectomy removes soft tissue only and is contraindicated where there is an infrabony component or inadequate keratinized tissue.
- C. Antibiotics are an adjunct; they cannot regenerate lost attachment.
- D. Osseous resection would sacrifice supporting bone in an esthetic anterior site and is better suited to shallow horizontal defects.