Case5
“Measure twice… and ( Don’t ) cut once…”
Larry Gelb, DMD
A 59 year old female presented with severe periodontitis associated with tooth #29. The defect is well defined by the gutta percha points positioned on the mesial, lingual, and distal surfaces of the tooth, revealing a deep trough defect on 3 of the 4 surfaces of the tooth.
The periodontal status is further characterized by the presence of sulcular inflammation, suppuration, and sub-gingival calculus. Prior to my seeing the patient, it was believed that the defect was of endodontic origin and root canal treatment was initiated. Upon accessing a perfectly healthy pulp, attention was redirected towards it being a problem of periodontal origin. At that point, the patient was referred to my office. Standard LPT-Laser Periodontal Therapy was provided in this localized area.
The 13 month post treatment evaluation reveals total resolution of the defect, minimal sulcular probing depths without any loss of tissue volume.
Periodontists with more of an orientation towards placing implants might have removed this tooth and placed the implant. However with a minimally invasive procedure, LPT, this patient will keep this tooth for many years. The longer we can retain teeth and delay placing implants the later we can concern ourselves with the risk of peri-implantitis and the more advanced the implant will be that we will use in the future.
