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ePaper created 2017-03-17, 12:41:55 | version 1.38.0
| research Fig. 24a Fig. 25a Fig. 26a Fig. 24b Fig. 25b Fig. 26b Fig. 27 Fig. 24a: A 12 mm deep pocket mb to ml 32. Fig. 24b: Initial X-ray. Fig. 25a: Three months later: 7 mm pocket depth. Fig. 25b: Beginning bone regeneration. Fig. 26a: Eleven months later, 5 mm pocket depth. protocol were applied. Here, it was very important to not go deeper than about 8 mm to prevent a devital- isation of 21 by SRP or laser irradiation. Figures 12 & 13 depict the situation six months later. The peri- odontal situation was normal and both teeth 21 and 22 had normal CO2 vitality. Figure 14 shows a clinically healthy periodontal situation three years later, less- ened symptoms and both teeth 21/22 CO2 positive. Fig. 26b: Final bone regeneration. Fig. 27: Two years later, healthy Case 4 clinical situation. Patient TA, a 70-year-old man came for a general consultation into our practice, with no pain. Canine 33 had an active, 12 mm deep periodontal pocket, shown in Figure 15 and the X-ray of 33 in Figure 16. The tooth was CO2 negative, the pocket’s cause: Endo/Perio. In the same session, we started end- odontic treatment for 33, the bridge was separated distally from 34, and we removed 37, did SRP for 33, and applied laser treatment protocol. Ten months later Figure 17 shows a little recession of the gum, a healthy periodontium, and in Figure 18 a very nice bone regeneration corresponding to the pocket’s anatomy. Five years later, no change in the periodon- tal situation of 33 was seen. Case 5 Patient BA, 71-year-old man was referred for peri- odontal treatment of tooth 16, with a 11 mm deep active pocket distobuccally and distopalatally. Pocket’s cause: food impaction as seen in Figure 19 between 16 and 17. Tooth 16 was CO2 vital and crowned. In a first session, we restored tooth 17 with a new composite filling to close the gap. Fig- ures 20 & 21 show the periodontal situation. In a second session, SRP was done and laser protocol was followed with four sessions. Eight months later, Figure 22a shows a healthy peri- odontal situation with a small recession of the gum and in Figure 22b the corresponding X-ray and visible regeneration of the bone can be seen. Two years later, we found a clinical, inactive 6 mm pocket (Fig. 23a), and in Figure 23b a radiologically acceptable situa- tion. Because of a heavy calculus formation we rec- ommended that the patient visit the dental hygienist three times a year. Case 6 Patient BL, a 69-year-old woman was referred for laser treatment of the 12 mm deep pocket at the me- siobuccal to mesiolingual side of tooth 32, with no pain, TM 4 and CO2 vitality. Pocket’s cause: occlusal dysfunction. Fig. 24a shows the initial clinical peri- odontal situation and Fig. 24b the initial X-ray of 32. After following the conventional treatment proto- col described in section 2.1, splinting 32 to 33, 41, 31, occlusal reseating and applying laser protocol in three sessions. Figure 25a shows the clinical state with 7 mm pocket depth and Figure 25b the beginning bone regeneration. After eleven months, 5 mm pocket depth remained as depicted in Figures 26a & b (final bone regeneration). Figure 27 shows the healthy clinical situation two years later. Case 7 Patient BS, a 55-year-old-woman, was referred by her diabetologist for a general periodontal consulta- tion. The only heavy periodontal problem was an ac- tive pocket of 12 mm mesially from tooth 24 and 11 mm distally and mesiopalatally from 23 due to food impaction and occlusal dysfunction, with TM 4 for tooth 24 and TM 3 for tooth 23. The pathogenic 14 laser 1 2017