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Treatment of a two wall defect in a mandibular posterior tooth with autogenous bone graft obtained during ledge removal with a hand instrument.

Sam G, Vadakkekuttical RJ, Harikumar K, Amol NV - J Indian Soc Periodontol (2015 Jul-Aug)

Bottom Line: Autogenous bone grafts have been considered the gold standard for bone grafting procedures.This case report describes the management of a two wall defect by utilizing the autogenous bone graft obtained during removal of ledges as a part of osteoplasty procedure.The bone was removed with a sickle scaler, and sufficient amounts of bone graft material were obtained to fill a two wall defect distal to left mandibular first molar.

View Article: PubMed Central - PubMed

Affiliation: Deptartment of Periodontics, Government Dental College, Kottayam, Kerala, India.

ABSTRACT
Autogenous bone grafts have been considered the gold standard for bone grafting procedures. This case report describes the management of a two wall defect by utilizing the autogenous bone graft obtained during removal of ledges as a part of osteoplasty procedure. The bone was removed with a sickle scaler, and sufficient amounts of bone graft material were obtained to fill a two wall defect distal to left mandibular first molar.

No MeSH data available.


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Figure 7: Sutures placed

Mentions: After giving block anesthesia in the left mandibular posterior area, internal bevel incision was given, and a full thickness flap was raised. Meticulous defect debridement and root planing was done to remove subgingival plaque, calculus, and inflammatory granulation tissue. A deep two wall defect was observed distal to first molar, heavy ledges were noticed extending bucally from second premolar to the second molar area [Figure 2]. First it was decided to remove the ledges as a part of osteoplasty procedure and then utilize the removed bone to fill the two wall defect. For this purpose, a sharp sickle scaler (PDT Cruise Scaler U15-33 R113, PDT Inc., US) [Figure 3] was used in a scrapping motion with sufficient force such that the bone was essentially shaved off [Figure 4]. The harvested bone was carefully collected in a dappen dish and then transferred to the defect with a periosteal elevator [Figures 5 and 6]. The flap was repositioned, single interrupted sutures were placed and periodontal dressing was given [Figures 7 and 8]. The patient was reviewed after 1-week, the healing was found to be uneventful. The sutures were removed, and the area was irrigated with saline. The patient was put on the maintenance phase with oral prophylaxis performed every 3 months. Radiographs were taken after 1-year. Clinically, there was a reduction in probing pocket depth from 7 mm to 3 mm [Figure 9]. Radiographs revealed radio opacity in the site distal to first molar, suggestive of bone fill in the defect [Figure 10].


Treatment of a two wall defect in a mandibular posterior tooth with autogenous bone graft obtained during ledge removal with a hand instrument.

Sam G, Vadakkekuttical RJ, Harikumar K, Amol NV - J Indian Soc Periodontol (2015 Jul-Aug)

Sutures placed
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555804&req=5

Figure 7: Sutures placed
Mentions: After giving block anesthesia in the left mandibular posterior area, internal bevel incision was given, and a full thickness flap was raised. Meticulous defect debridement and root planing was done to remove subgingival plaque, calculus, and inflammatory granulation tissue. A deep two wall defect was observed distal to first molar, heavy ledges were noticed extending bucally from second premolar to the second molar area [Figure 2]. First it was decided to remove the ledges as a part of osteoplasty procedure and then utilize the removed bone to fill the two wall defect. For this purpose, a sharp sickle scaler (PDT Cruise Scaler U15-33 R113, PDT Inc., US) [Figure 3] was used in a scrapping motion with sufficient force such that the bone was essentially shaved off [Figure 4]. The harvested bone was carefully collected in a dappen dish and then transferred to the defect with a periosteal elevator [Figures 5 and 6]. The flap was repositioned, single interrupted sutures were placed and periodontal dressing was given [Figures 7 and 8]. The patient was reviewed after 1-week, the healing was found to be uneventful. The sutures were removed, and the area was irrigated with saline. The patient was put on the maintenance phase with oral prophylaxis performed every 3 months. Radiographs were taken after 1-year. Clinically, there was a reduction in probing pocket depth from 7 mm to 3 mm [Figure 9]. Radiographs revealed radio opacity in the site distal to first molar, suggestive of bone fill in the defect [Figure 10].

Bottom Line: Autogenous bone grafts have been considered the gold standard for bone grafting procedures.This case report describes the management of a two wall defect by utilizing the autogenous bone graft obtained during removal of ledges as a part of osteoplasty procedure.The bone was removed with a sickle scaler, and sufficient amounts of bone graft material were obtained to fill a two wall defect distal to left mandibular first molar.

View Article: PubMed Central - PubMed

Affiliation: Deptartment of Periodontics, Government Dental College, Kottayam, Kerala, India.

ABSTRACT
Autogenous bone grafts have been considered the gold standard for bone grafting procedures. This case report describes the management of a two wall defect by utilizing the autogenous bone graft obtained during removal of ledges as a part of osteoplasty procedure. The bone was removed with a sickle scaler, and sufficient amounts of bone graft material were obtained to fill a two wall defect distal to left mandibular first molar.

No MeSH data available.