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Revista odontológica mexicana
Print version ISSN 1870-199X
Rev. Odont. Mex vol.12 n.4 Ciudad de México Dec. 2008
https://doi.org/10.22201/fo.1870199xp.2008.12.4.15628
Casos clínicos
Procedimientos quirúrgicos reconstructivos en el tratamiento de la periodontitis agresiva localizada: reporte de un caso clínico
Reconstructive surgical procedures in the treatment of localized aggressive periodontitis: Case report
*Alumno de la Especialidad de Periodoncia. División de Estudios de Postgrado e Investigación de la Facultad de Odontología de la UNAM.
§Profesor de la Especialidad de Periodoncia. División de Estudios de Postgrado e Investigación de la Facultad de Odontología de la UNAM.
La periodontitis agresiva localizada ocasiona destrucción ósea severa alrededor de dientes específicos, por lo que en un mismo paciente se encuentran defectos óseos en los que se рuеden realizar procedimientos quirúrgicos enfocados a la reconstrucción de los tejidos periodontales perdidos.
Objetivo
Valorar clínica y radiográficamente los resultados de procedimientos quirúrgicos periodontales reconstructivos utilizando autoinjertos óseos intraorales solos o combinados con otros materiales de reconstrucción.
Caso clínico
Un paciente con periodontitis agresiva localizada, fue tratado con 4 diferentes procedimientos quirúrgicos reconstructivos: 1) autoinjerto óseo combinado con material aloplástico, 2) autoinjerto óseo solo, 3) autoinjerto óseo con membrana absorbible, y 4) autoinjerto óseo mezclado con plasma rico en factores de crecimiento.
Resultados
Los resultados se evaluaron clínica y radiográficamente entre los 9 y los 12 meses postoperatorios. Clínicamente se detectó una disminución en la profundidad al sondeo de 10 a 4 mm como valores extremos, encontrándose recesión gingival ≤ 3 mm en los sitios tratados. Radiográficamente, en todos los defectos se apreció llenado óseo.
Conclusión
Los procedimientos quirúrgicos reconstructivos que utilizan autoinjertos óseos intraorales, ya sea solos o combinados con otros materiales de reconstrucción, son una buena alternativa en el tratamiento de los defectos intraóseos periodontales en periodontitis agresiva, ya que permiten mejoría de los parámetros clínicos y radiográficos.
Palabras clave: Regeneración periodontal; cirugía periodontal reconstructiva; autoinjertos óseos; materiales aloplásticos; plasma rico en factores de crecimiento; regeneración tisular guiada
Localized aggressive periodontitis produces severe osseous destruction around specific teeth that is why in one patient different sites can be surgically treated, focusing on the regeneration of the missing periodontal tissue.
Objective
To evaluate clinically and radiographically the results of the surgical reconstructive periodontal procedures, using osseous self-grafts, either on their own or combined with other regenerative materials.
Case report
A patient with a clinical diagnosis of localized aggressive periodontitis was treated with 4 different surgical procedures: 1) osseous self-graft combined with alloplastic materials, 2) simple osseous self-graft, 3) osseous self-graft combined with absorbable membrane, and 4) osseous autograft combined with EPGF.
Results
The results were evaluated clinically and radiographically between 9 and 12 months after surgical procedures. Clinically there was a reduction in PD from 10 to 4 mm in extreme values, with recessions ≤ 3 mm in the treated areas. Radiographically in all sites there were an osseous filling.
Conclusions
The reconstructive surgical procedures that use osseous intraoral self-grafts, either on their own or combined with other reconstructive materials are a good alternative in the treatment of periodontal defects, because an increase in osseous level and reduction in PD is observed.
Key words: Periodontal regeneration; reconstructive periodontal surgery; autogenous bone grafts; alloplastic materials; enriched plasma with growth factors; guided tissue regeneration
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