Abstract

Introduction:  There are several techniques to treat and maintain teeth affected by stage III, grade C periodontitis, nonetheless, the scientific evidence available on how periodontal clinical parameters and microbiological composition may be modified during the conventional and surgical treatment is scarce.

Objective:  To evaluate the clinical and microbiological response of a patient with stage III grade C, generalized periodontitis, during 5 years, treated with non-surgical and surgical periodontal therapy using regenerative material and bone substitute.

Methodology:  The patient was treated with scaling and progressive root planning, combined with antibiotics and surgical therapy was performed in sites with infraosseous defects. At each time of treatment, subgingival bacterial plaque (PB), haemorrhage (H), probing depth (PD) and clinical attachment level (CAL) were recorded. To identify periodontal bacteria by molecular biology samples were taken with endodontic cones from the pocket depth.

Results:  A significant difference of PB, H, PD was observed. The PD decreased and CAL was gained throughout the treatment. PD decreased 5 mm with the application of bone substitute, and CAL gained 5 mm, with the use of amelogenins the difference of PD and CAL was 4.5 mm. In access flap the PD decreased 3 mm and the CAL improved 2 mm. T. denticola was identified at 36 months in all pockets treated with access flap and in 50% of the pockets with bone graft, and P. gingivalis at 60 months.

Conclusions:  The periodontal treatment applied prevented the loss of the affected teeth. Improvement of clinical parameters was associated with a non-aggressive microbiota.

Key words: Periodontal disease; oral microbiology, periodontal debridement, therapeutics.