Periodontal Regenerative Therapy with Enamel Matrix Derivative in Patient with Chronic Periodontitis: A 3.5-year Follow-up Report

: Here, we report periodontal treatment including regenerative therapy in a patient with generalized chronic periodontitis. The patient was a 53-year-old woman who presented with the chief complaint of gingival swelling and tooth mobility in the right maxillary molar region. An initial examination revealed 36% of sites with a probing depth of ≥4 mm and 15.5% with bleeding on probing. Radiographic examination revealed vertical bone resorption in #15, 24, 27, 34, 37, 45, and 47. Horizontal resorption was noted in other regions. The clinical diagnosis was moderate chronic periodontitis. Initial periodontal therapy consisted of plaque control, scaling, and root planing together with treatment for caries. Occlusal adjustment of premature contact sites was performed after suppression of inflammation. Periodontal regenerative therapy using enamel matrix derivative was performed on #15, 24, 34, 45, and 47. Other sites with residual periodontal pockets were treated by open flap debridement. Tooth #27 was extracted due to a bone defect exceeding the root apex; #37 was extracted due to frequent acute symptoms following periodontal surgery. Following re-evaluation, the patient was placed on supportive periodontal therapy. Periodontal regenerative therapy improved vertical bone resorption. This improvement has been adequately maintained over a 3 years 6 months period. Additional care is necessary, however, to further improve the patient's oral health-related quality of life during supportive periodontal therapy.