Two-wall defect in mandibular tooth treated with autogenous bone graft.

| Posted in: Science

Journal name: Journal of Indian Society of Periodontology
Original article title: Treatment of a two wall defect in a mandibular posterior tooth with autogenous bone graft obtained during ledge removal with a hand instrument
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

George Sam, Rosamma Joseph Vadakkekuttical, Kanakkath Harikumar, Nagrale Vijay Amol


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Treatment of a two wall defect in a mandibular posterior tooth with autogenous bone graft obtained during ledge removal with a hand instrument

Year: 2015 | Doi: 10.4103/0972-124X.154191

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

Autogenous bone grafts are historically regarded as the gold standard in bone grafting procedures, particularly in regenerative periodontal therapy aimed at restoring lost tooth-supporting bone due to periodontitis. This case report illustrates the management of a two-wall defect using autogenous graft material harvested during an osteoplasty procedure. The use of autogenous grafts, which can be obtained from several intraoral and extraoral sites, not only aids in bone regeneration but also minimizes the need for additional donor sites, thus reducing patient morbidity.

Efficient Grafting through Ledge Removal

One key concept presented in this case report is the innovative technique of harvesting autogenous bone during the removal of ledges in the mandibular area. The surgical process involved the careful scraping of bone using a sharp sickle scaler, resulting in sufficient graft material to fill a two-wall defect distal to the left mandibular first molar. This technique enabled the practitioner to avoid traditional rotary instruments, which often result in inadequate graft material and potential bone overheating. The simplicity and effectiveness of using a sickle scaler highlight an alternative approach to bone harvesting that can be just as efficient as specialized instruments, showing promise for routine clinical application.

Conclusion

The successful use of autogenous grafts in this case reinforces their continued importance in periodontal regenerative procedures due to their excellent biological properties. By utilizing less conventional techniques, such as the removal of ledges with a sickle scaler, dental practitioners can ensure effective bone harvesting while simplifying the surgical process. The findings advocate for a reevaluation of existing harvesting methods and emphasize that common periodontal instruments can still achieve significant outcomes in bone regeneration, ultimately benefiting patient care and treatment efficiency.

FAQ section (important questions/answers):

What are autogenous bone grafts used for in dentistry?

Autogenous bone grafts are considered the gold standard for bone grafting procedures due to their superior biologic properties. They are used to restore lost bone tissue, particularly in cases of periodontal disease, by promoting bone regeneration.

How was the autogenous bone graft obtained in the case report?

The autogenous bone graft was harvested using a sharp sickle scaler. This technique involved scraping the ledges present on the mandibular posterior area, allowing for sufficient amounts of bone to be collected for filling a two wall defect.

What are some advantages of using autogenous bone grafts?

Autogenous bone grafts are bioabsorbable, nonallergenic, easy to handle, and have rapid revascularization, facilitating the healing process. They also release growth and differentiation factors, enhancing bone regeneration.

What is the significance of the patient's 1-year follow-up?

The 1-year follow-up revealed a significant reduction in probing pocket depth from 7 mm to 3 mm and radiographic evidence of bone fill in the defect, indicating successful healing and regeneration after the graft procedure.

What limitations exist for harvesting intraoral graft material?

Harvesting intraoral graft material is limited by available donor sites within the oral cavity, making it challenging to obtain sufficient graft material for extensive periodontal regeneration.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Two-wall defect in mandibular tooth treated with autogenous bone graft.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
The term 'Table' does not appear explicitly in the text. However, it is often used in medical contexts to refer to organized presentation of data, such as patient information, results of studies, or treatment outcomes. Such tables are key in summarizing and comparing information for analyses in clinical research.

2) Grafting:
Grafting refers to the surgical procedure of placing living tissue into a defect to promote healing and restore function. In this context, autogenous bone grafting is highlighted as the gold standard for periodontal repair, providing biological benefits and addressing bone loss caused by diseases like periodontitis.

3) Wall:
In periodontology, the term 'Wall' often pertains to the structural aspects of bone defects in the jaw. The case report specifically discusses a two-wall defect, which denotes the structure's integrity and the necessity for bone grafting to restore lost architecture and support gum tissue.

4) Harvesting (Harvest):
Similar to 'Harvesting', 'Harvest' denotes the process of obtaining bone for grafting procedures. The report highlights the effective harvesting of autogenous bone during surgery, signifying a crucial step in enhancing the regenerative capacity of periodontal tissues, crucial for successful restoration of bone integrity.

5) Relative:
The term 'Relative' is not explicitly used in the text. However, it could refer to comparative aspects of various bone grafting techniques, the effectiveness of autogenous grafts relative to other materials, or the relevance of surgical outcomes to various factors involved in periodontal therapy.

6) Gold (Golden):
The term 'Gold' predominantly describes the autogenous bone graft as the gold standard in grafting materials. This designation signifies its superior biological properties, including osteogenic potential, and preferential usage over alternative grafting options in restorative procedures for periodontal and bone defects.

7) Dressing:
In the provided text, 'Dressing' refers to the periodontal dressing applied post-surgery. It plays a crucial role in protecting the surgical site, promoting healing by supporting the stabilizing of the tissue flaps, and preventing infection, ultimately contributing to the success of the grafting procedure.

8) Bleeding:
The term 'Bleeding' highlights one of the symptomatic presentations of periodontal disease in the patient. It indicates inflammation and disease progression that necessitated intervention. Understanding bleeding patterns is essential in diagnosing periodontal conditions and determining appropriate treatment strategies to restore periodontal health.

9) Surface:
In dentistry, 'Surface' generally refers to the interface between tissues and graft materials or the oral environment. The text discusses the need for a smooth and blended surface post-grafting to ensure proper soft tissue adaptation, crucial for healing and optimizing periodontal surgical outcomes.

10) Transformation (Transform, Transforming):
Transforming in this context relates to regenerative processes where grafting materials or techniques lead to changes in tissue morphology or function. This could refer to how autogenous bone enhances the healing and regenerative capabilities of the jawbone post-therapy, facilitating better attachment and integration of tissues.

11) Discussion:
The term 'Discussion' refers to a critical section in the study where findings are interpreted, and implications are analyzed. It serves to contextualize the results of the grafting procedure, evaluating the efficacy of the technique used and addressing future considerations in periodontal surgery and grafting methodologies.

12) Knowledge:
Knowledge in this context encompasses the clinical understanding required for effective periodontal treatment. The report emphasizes the importance of evidence-based practice, reflecting on leveraging various techniques and innovative approaches like using a sickle scaler for bone harvesting in enhancing patient outcomes.

13) Incision:
The term 'Incision' refers to the surgical cut made during periodontal surgery to access the affected area. The text describes specific techniques for incisions that facilitate flap elevation, allowing thorough debridement and appropriate placement of the harvested bone graft, vital for successful periodontal regeneration.

14) Disease:
In this context, 'Disease' primarily refers to periodontal disease, which results in the loss of tooth-supporting bone. Understanding the pathophysiology of such diseases is essential as they necessitate treatments like grafting to restore bone integrity and halt disease progression, improving patients' oral health.

15) Repair:
The term 'Repair' signifies the primary goal of periodontal interventions, aiming to restore damaged tissues, particularly bone structures, following periodontal disease. Grafting with autogenous bone serves as a means of repair, facilitating regeneration and promoting re-establishment of functional periodontal attachments to teeth.

16) Water:
While 'Water' is not highlighted directly, this term is relevant in surgical contexts where irrigation is utilized to cool instruments like drills during bone harvesting. In the context of this report, managing temperatures is critical to preserving bone viability and optimizing the harvesting process.

17) Study (Studying):
The term 'Study' refers to the documented case report that evaluates the efficacy of using autogenous grafts obtained via a unique technique during periodontal surgery. This adds to the existing body of research on grafting methods and their outcomes, contributing to better clinical practices.

18) Male:
The term 'Male' is used to describe the patient demographic involved in the discussed case report. Understanding patient characteristics is vital in clinical research as it can impact the approaches taken for treatment, outcomes, and interpretation of results in periodontal surgeries.

19) Dish (Dis):
In this context, 'Dish' refers to the surgical receptacle used to collect the harvested bone graft material. Using a dappen dish aids in the careful handling and transfer of the autogenous bone, essential for ensuring sterility and effective application during the bone graft placement.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Two-wall defect in mandibular tooth treated with autogenous bone graft.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Postoperative care, Surgical Site, Radiographic examination, Chronic generalized periodontitis, Bone grafting material, Maintenance phase.

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