Dr. Arthur Brincat

This case presents a severe periodontal lesion with a 13 mm probing depth, suppuration on probing, and a deep infra-osseous defect. Clinical examination revealed that the lingual bony wall was missing, complicating regenerative management. A unilateral lingual flap was elevated with papilla preservation to ensure minimal trauma to the interdental tissues. Inflammatory tissue was carefully removed, creating a clean environment for regeneration.

To reconstruct the missing lingual wall, mucoderm^® was applied as a soft tissue scaffold to replace the deficient bony support. The infra-osseous defect was then filled with cerabone^® +HyA, chosen for its volume stability, supporting predictable bone regeneration. Primary closure was achieved using horizontal mattress and single interrupted sutures. Post-operative imaging included immediate post-op radiograph for baseline evaluation and 6-month periapical radiograph, confirming stable bone augmentation. Clinically, probing depths reduced from 13 mm initially to 2 mm at 6 months, with no soft tissue recession, demonstrating successful regeneration and soft tissue management.