1. Emergency treatment for the periodontal abscess which will include local debridment, systemic antibiotics, OHI, and physician consult to control systemic blood glucose levels.2. Oral Hygiene Instruction - Flossing, Proxybrush and End tuft brush. Modified Bass Technique. 3. Scaling and Root planing under local anesthesia by quadrants. 4. Nightguard applicance for space maintainence, bruxing, and fremitus.
5. Evaluation of response to Phase I therapy and review of OHI. Presurgery. Oral hygiene level was greater than 90 % plaque free surfaces. Patients blood glucose normalized due to compliance with medication utilization and diet modification. 6.Surgical therapy localized to posterior quadrants with the exception of lower right quadrant which responded well to Phase I therapy with minimal probing depths (approx. 4mm) after Phase I Therapy
Teeth #2-6: Full thickness flap with osseous recontouring was achieved with post-operative treatment including 2 weeks Peridex and 7 days systemic antibiotics.
Teeth #14-15: Combination resective and regenerative procedures using autogenous bone and tetracycline root conditioning. Full thickess flap designed so that there was primary closure over the grafted material. Osseous surgery also preformed during surgery. Post operative treatment including 2 weeks Peridex and 1 week systemic antibiotic.
Teeth #18-20: Resective surgery completed with scalloped full thickness and osseous recontouring. Post-operative treatment including 2 weeks Peridex 7 days systemic antibiotics.
7. Restorative phase: To be completed by outside dentist which include: Fixed bridge #12-#14. For space maintenance and correction of marginal ridge discrepancy; replacement of defective resorations #3 and #4, #20. 8. Supportive Periodontal Therapy: -3 Month supportive therapy. -OHI tailored to specific areas of dentition. -Gingival tissues monitored for increasing pocket depth and inflammation. -Supragingival plaque and calculus removal.
