By:  Victor M. Sternberg, D.M.D.

May 11, 2022

A 93 year old patient, in otherwise good health both mentally and physically,  presented with discomfort and a deep pocket on the facial of tooth #15.

The pocket probed to the apex. The gutta percha shows the depth  Interestingly enough the tooth did not have severe mobility.  The mobility was in the range of 1.

Given the difficulty of replacing this tooth the patient acquiesced to a procedure to see if it was possible to repair the facial defect.

A bone graft was elected that might repair the apical third of the defect where there was bone surrounding the walls as opposed to the more coronal portion.

A bone graft and a membrane were placed.

The final photograph taken a year later shows that despite probing to the point of discomfort, the pocket had closed and the tooth was stable.

There is no question that she had some bone fill to amplify the final x-ray but most of the bone fill is in the apical third.  The remainder of the attachment was probably a combination of connective tissue and a long epithelial junction.

In any event, the tooth at this point is manageable and maintainable.

Given the alternatives of extraction and prosthetic replacement, as well as the difficulty of placing an implant in this site, the outcome obtained by treating in the manner that was performed hopefully will justify this approach.

As always I appreciate your feedback.

Yours truly,

Victor M. Sternberg, D.M.D.

By Westchester Center for Periodontal & Implant Excellence

January 15, 2023