Читать книгу Clinical Cases in Periodontics - Группа авторов - Страница 101

After the patient’s initial examination, radiographs, and charting (Figures 1.6.1–1.6.3), a comprehensive treatment plan was presented and agreed upon. The first session involved full‐mouth gross scaling and oral hygiene instructions on the proper toothbrushing technique and use of dental floss. Due to the presence of large amounts of subgingival calculus, the patient required six sessions of subgingival SRP under local anesthesia (one sextant of the mouth was instrumented per session). During this active phase of anti‐infective therapy, previously instrumented sextants were constantly reexamined for residual supragingival and subgingival calculus, and whenever detected, residual calculus was removed. Every SRP session was accompanied by reinforcement of the oral hygiene instructions.

Three months after the last SRP session, the patient was reexamined (Figures 1.6.4 and 1.6.5), residual pockets ≥4 mm received additional SRP, a full‐mouth plaque removal was performed, and oral hygiene instructions reinforced. Mean full‐mouth PD and CAL were reduced to 2.3 and 2.4 mm, respectively, and there was a reduction in BOP to 13%. At that time no additional periodontal therapy was deemed necessary. The patient was placed in a recall system for supportive periodontal therapy every three months. Figures 1.6.6 and 1.6.7 illustrate the clinical presentation and the periodontal parameters one year after completion of SRP.

Figure 1.6.3 Full‐mouth periapical radiographs of the case at initial visit.

Source: courtesy of Dr. Eduardo Sampaio and Dr. Marcelo Faveri.

Figure 1.6.4 Clinical presentation of the case three months after therapy.

Source: courtesy of Dr. Eduardo Sampaio and Dr. Marcelo Faveri.