20-year follow-up of a bony defect
A clinical case report by Carlos E. Nemcovsky, Israel
Being one of the first users of Emdogain®, Prof. Nemcovsky comments on the product introduction and underlines the long-term success the product is able to provide in regenerative therapies.
Author: Carlos E. Nemcovsky
Interview with Professor Nemcovsky on 20 years of Emdogain
Related products and topics
Initial situation
A systemically healthy 17-year old patient was diagnosed with a localized severe aggressive periodontitis. A pre-operative X-ray revealed an intra-bony defect in the mesial aspect of the first lower right molar (Fig. 1). Following the initial preparation, a remaining 10mm-periodontal pocket was evident (Fig. 2).
Procedure
Treatment planning: A regenerative periodontal surgery with Emdogain® and bone graft was scheduled.
Surgical procedure
Following intrasulcular incisions and a full thickness flap elevation, thorough debridement was performed. An intrabony lesion, which could be classified as a 1-wall defect in the coronal area, while in the apical area, a 2- or 3-wall defect became evident (Fig. 3), 10 mm CAL was confirmed. Root conditioning with PrefGel® was performed. After rinsing and slightly drying the area with gauze pads, Emdogain® was applied on the exposed root surface and into the defect (Figs. 4-5). Bone grafting was performed and the area sutured to achieve primary soft tissue closure (Fig. 6).
Treatment outcome
An immediate post-operative radiograph captured the bone graft in place (Fig. 7). The next sequence of radiographs shows the gradual bone fill of the defect at six months (Fig. 8), 3 years (Fig. 9), seven years (Fig. 10) and twenty years (Fig. 11).
