Periodontal Surgery Using Recombinant Human Fibroblast Growth Factor-2 in Combination with Carbonate Apatite Granules for Stage III Grade C Periodontitis: A 30-month Case Report

Abstract

This report describes a case of generalized aggressive periodontitis requiring periodontal treatment including regenerative therapy. The patient was a 34-year-old woman who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of pain in tooth #14. An initial examination revealed that 35.8% of sites had a probing depth of ≥4 mm, while 19.1% showed bleeding on probing. Radiographic examination revealed angular bone resorption in #14, 33, 36, and 46, with horizontal resorption in other areas. Based on a clinical diagnosis of Stage III Grade C periodontitis, initial periodontal therapy consisting of plaque control, and scaling and root planing was performed. After reevaluation, periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) in combination with carbonate apatite (CO3Ap) granules was performed for #14 and 33, while regenerative therapy using rhFGF-2 alone was performed for #46. Following reevaluation, the patient was placed on supportive periodontal therapy (SPT). During SPT, CAD/CAM crowns were placed on #26 and 46. Periodontal regenerative therapy using rhFGF-2 with CO3Ap granules yielded a resolution of angular bone defects in #14 and 33. This improvement has been adequately maintained over a 30-month period.