Management of an endo perio lesion in a maxillary canine using platelet-rich plasma concentrate and an alloplastic bone substitute

Abstract

To evaluate the efficacy of platelet-rich plasma concentrate in the management of a cirumferential, infrabony defect associated with an endoperio lesion in a maxillary canine. A 45 year-old male patient with an endoperio lesion in the left maxillary canine was initially treated with endodontic therapy. Following the endodontic treatment, the circumferential, infrabony defect was treated using platelet-rich plasma and an alloplastic bone substitute. At the end of three months, there was a gain in the clinical attachment level and reduction in probing depth. Radiographic evidence showed that there was significant bony fill. The results were maintained at the time of recall nine months later.

Keywords: Endoperio lesion; infrabony defect; platelet-rich plasma.

Figure 1

a) Periodontal probing depth was 8 mm mesially; b) Probing depth of 6 mm labially; c) Probing depth of 7.5 mm distally; d) A periapical radiograph showed a widening of the periodontal ligament space in the periapical area with an infrabony defect on the mesial aspect

Figure 2

a) The site was surgically opened up for debridement and a circumferential defect was evident around the tooth; b) The platelet-rich concentrate obtained after centrifugation; c) The platelet-rich concentrate was mixed with an alloplastic bone graft substitute and the mix obtained had a gel-like consistency; d) This gel was placed to cover the exposed root and fill the defect

Figure 3

a) The periodontal pockets had reduced from 8 mm to 0.5 mm mesially; b) The periodontal pockets had reduced from 6 mm to 1 mm labially; c) The periodontal pockets had reduced from 7.5 mm to 1 mm distally; d) Radiographically, a significant bony fill was evident after nine months