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ePaper created 2012-12-10, 10:37:05 | version 1.22.16
38 I I case study_ Implant therapy implants2_2012 _Deep periodontal defects with ad- vanced bone loss of the buccal cortical plate represent a challenge for peri- odontal treatment in the upper front region. Literature data suggest that one and two-wall periodontal defects do not have tendency for complete periodontal regeneration and bone fill (Eickholz et al. 1996, 1998, 2000). Remaining re- sidual pockets can also jeopardise the long term result of periodontal treat- ment (Matuliene et al. 2008). Tooth ex- traction in the upper front region even without any periodontal defect will re- sult in certain amount of oro-vestibular and eventually vertical shrinkage of the original soft tissue contour (Schropp et al. 2003). Due to bone remodelling ap- propriate implant placement cannot be achieved in most of the cases. Socket preservation and different alveolar site developments are used to offset this unfavourable feature (Camargo & Le- kovic, 2004; Lekovic & Kenney, 1997). It is obvious that the application of one of these techniques can be of great impor- tance when tooth extraction is being considered at periodontally compro- mised teeth with advanced buccal plate involvement. It is not clear that ridge preservation procedures are effec- tive in limiting horizontal and vertical ridge alterations in postextraction sites. Comparing the clinical and histological results obtained by different preserva- tion techniques there is no literature data to support the superiority of one Implant therapy of edentulous sitesAuthor_ Dr Peter Windisch Fig. 1a Fig. 1b Fig. 2 Fig. 3 Fig 1a_Clinical view of tooth 12 prior treatment with similar recession on tooth 13. Distal papilla of 11 is missing. Fig 1b_Standardised X-ray at baseline. The #12 tooth has a deep intrabony defect on the mesial aspect. Fig. 2&3_- Advanced periodontal breakdown at the upper right lateral incisor. The bony defect involves the buccal plate of bone. The neighbouring tooth has also intrabony periodontal defect.