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Periodontics · patient case question

Guided tissue regeneration is best indicated for which bone loss pattern and furcation grade?

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.

  1. Class IV furcation with complete recession
  2. Vertical (infrabony) bone loss and Class II furcation involvement
  3. Class III through-and-through furcation
  4. Generalized horizontal bone loss
Show answer and explanation

Correct answer: B. Vertical (infrabony) bone loss and Class II furcation involvement

  • A. Class IV furcations, fully open and visible, are the least favorable of all for regeneration.
  • B. Correct. Vertical defects with retained bony walls, and Class II furcations where the probe only partially enters, provide the containment a membrane needs to work.
  • C. A through-and-through Class III defect cannot be predictably regenerated.
  • D. Horizontal bone loss offers no space for regeneration to occur and responds poorly to GTR.

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