PMC6070683_01
(A) Clinical examination demonstrated a probing pocket depth of 6 mm 21 facial aspect. (B) Radiographic examination revealed loss of bone levels in relation to 21 and 11.
gr1.jpg
PMC6070683_01_gr1.jpg
fig0005
Also, 4 mm and 6 mm probing depth were detected distal to 11 and mesial to 21 respectively along with clinical attachment loss of 8 mm (Fig. 1a). Radiographic examination revealed horizontal bone loss mesial to 21 (Fig. 1b), which gave the diagnosis of localised chronic periodontitis for 21 and 11.
Whale's tail full-thickness mucoperiosteal flap elevated in relation to 21 and 11.
gr2.jpg
PMC6070683_01_gr2.jpg
fig0010
Crevicular incisions were made in the mesiobuccal, interproximal, and palatal aspects of 21 and 11 (Fig. 2).
(a) Management of the recipient site. Bone graft placed. (b) Management of the recipient site. GTR membrane placed.
gr3.jpg
PMC6070683_01_gr3.jpg
fig0015
Bone graft (Perioglas ) was placed along with GTR membrane (Healiguide ) covering the defect (Fig. 3a, b), following which flap was repositioned back. 4-0 Ethicon, non-resorbable, perimeter sutures were placed, without tension, away from the margins (Fig. 4).
Perimeter sutures placed and the Whale's tail flap secured for primary closure.
gr4.jpg
PMC6070683_01_gr4.jpg
fig0020
Bone graft (Perioglas ) was placed along with GTR membrane (Healiguide ) covering the defect (Fig. 3a, b), following which flap was repositioned back. 4-0 Ethicon, non-resorbable, perimeter sutures were placed, without tension, away from the margins (Fig. 4).
(a) Healing of the recipient site 12 months postoperatively. (b) Radiographic examination after 12 months post-op revealing bone fill.
gr5.jpg
PMC6070683_01_gr5.jpg
fig0025
The result was stable and aesthetically satisfactory (Fig. 5a) until 12 months. A slight increase in bone height was also noted radiographically (Fig. 5b) when examined at 12 months post-op.