A Case Report of Periodontal Regenerative Therapy Using Recombinant Human Fibroblast Growth Factor 2 and Deproteinized Bovine Bone Mineral with Non-incised Papillae Surgical Approach (NIPSA) for Angular Bone Defect in Patient with Stage III Grade C Periodontitis

Bull Tokyo Dent Coll. 2023 Dec 28;64(4):145-155. doi: 10.2209/tdcpublication.2023-0011. Epub 2023 Nov 15.

Abstract

This report describes a case of Stage III Grade C periodontitis requiring periodontal regenerative therapy. The patient was a 19-year-old woman who presented with the chief complaint of gingival recession in the incisor region. An initial examination revealed that 45.3% of sites had a probing depth of ≥4 mm and 45.8% bleeding on probing. Radiographic examination showed angular bone resorption in #25, 26, 31, 36, and 46 and horizontal resorption in other regions. Initial periodontal therapy was implemented based on a clinical diagnosis of Stage III Grade C periodontitis (generalized aggressive periodontitis). Occlusal adjustment was also performed at sites showing premature contact (#26 and 36) after suppression of inflammation. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF) -2 was performed on #25, 26, and 46. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #31 and 36. A non-incised papillae surgical approach (NIPSA) was used on #31. Periodontal conditions were then re-evaluated and the patient placed on supportive periodontal therapy. Regenerative therapy using rhFGF-2 and DBBM with NIPSA yielded an improvement in clinical parameters and bone resorption. This improvement has been adequately maintained over a 12-month period. Continued care is needed to maintain stable periodontal conditions.

Keywords: Deproteinized bovine bone mineral; Intrabony defects; NIPSA; Periodontal regenerative therapy; Recombinant human fibroblast growth factor (rhFGF) -2.

Publication types

  • Case Reports

MeSH terms

  • Aggressive Periodontitis* / surgery
  • Alveolar Bone Loss* / surgery
  • Animals
  • Cattle
  • Female
  • Fibroblast Growth Factor 2 / therapeutic use
  • Follow-Up Studies
  • Gingival Diseases* / surgery
  • Guided Tissue Regeneration, Periodontal
  • Humans
  • Minerals / therapeutic use
  • Periodontal Attachment Loss
  • Treatment Outcome
  • Young Adult

Substances

  • bone meal
  • Fibroblast Growth Factor 2
  • Minerals