Clinical case description:
1. Preoperative probing at tooth 21 of 13 mm probing depth and x-ray with probe until the apex of the tooth.
2. Intraoperative probing at tooth 21 with a severe bone loss beyond the apex and absence of buccal and interproximal bone. Florida probing of the sextant.
3. Enamel matrix derivatives are applied on the roots surfaces in combination with a particulated bovine xenograft Geistlich Bio-Oss®.
4. A bioabosorbable collagen membrane is adapted to the roots morfology covering the biomaterial.
5. Primary closure with a 0-7 Gore-tex suture with horizontal internal mattress suture and vertical internal mattress suture at the tip of the papilla.
6. Post-operative healing of the patient 9 days after the surgical procedure. Note the primary intention healing of the wound.
7. Radiographic evolution of tooth 21 between baseline, 6 months and 2 years post-surgery with a radiographic stability of the interproximal bone.
8. Clinical situation of tooth 21 2 years after the regenerative procedure with a 1 mm increase recession on the bucco-distal aspect and a 5 mm probing depth. Florida probing chart with a clinical attachment gain of 8 mm at the bucco-distal aspect of 21.