Complications and treatment errors related to regenerative periodontal surgery

Abstract

Regenerative periodontal surgical procedures are an important component in the treatment of advanced periodontitis. They aim to improve the long‐term prognosis of teeth that are periodontally compromised by the presence of intrabony and/or furcation defects, resulting biologically in formation of root cementum, periodontal ligament, and alveolar bone and evidenced clinically by reduction of deep pockets to maintainable probing depths and/or improvements of vertical and horizontal furcation depth. Over the last 25 years, substantial clinical evidence has been accumulated to support the value of regenerative procedures in periodontally compromised dentitions. However, treatment success requires close attention to certain factors on the level of the patient, the tooth/defect, and the operator. Ignoring these factors in case selection, treatment planning, and treatment execution will increase the risk of complications that may jeopardize clinical success and may even be considered as treatment errors. Based on the currently available evidence from clinical practice guidelines, treatment algorithms, and on expert opinion, the present article provides an overview on the main factors, which influence the outcomes of regenerative periodontal surgery and gives recommendations on how to prevent complications and treatment errors.

Regeneration of Intrabony Defects Using a Novel Magnesium Membrane

“…In a recent review by Jepsen et al, it was stated that the defect morphology plays an important role in the outcome of the regenerative treatment and that the choice of biomaterial should be taken into consideration as a part of the strategy for the treatment [42]. One example provided was the use of titanium-reinforced barrier membranes to treat "non-contained" IBDs.…”

Management of Teeth with Grade 3 Endo-Periodontal Lesions by Combined Endodontic and Regenerative Periodontal Therapy

“…Apical split flap preparation was only performed if needed for primary tension-free flap closure. After meticulous debridement of the defect with curettes, sonic/ultrasonic devices the biomaterial was selected depending on the configuration of the intra-bony defect [ 6 , 13 , 26 ]. To avoid a soft-tissue collapse into the defect, a bone filler was used (DBBMc, Bio Oss ® Collagen; Geistlich, Wolhusen, Switzerland).…”

Furcation Involvement in Periodontal Disease: A Narrative Review

“…Stavropoulous et al have reported in their systematic review and meta-analysis that regenerative periodontal therapy have a better outcome in intrabony defects, in shallow pockets, and when administered as a combination therapy [ 30 ]. Jepsen et al also reported that careful case selection with meticulous diagnosis, appropriate micro-surgical techniques, and high motivation in patients for periodic maintenance are crucial for a successful outcome [ 31 ].…”