Stage III Grade C Periodontitis: 10 Yıllık İdame Protokolü ile Uzun Dönem Başarı Olgu Sunumu

Öz

1999 sınıflamasında hızlı ilerleyen bir periodontal hastalık şeklinde tanımlanan agresif periodontitis, 2017 Dünya Periodontoloji Workshop’unda kabul edilen yeni sınıflandırma sisteminde, evreleme (Stage) ve derecelendirme (Grade) kriterlerine göre yeniden kategorize edilmiştir. Bu olgu sunumunda, Stage III, Grade C periodontitis tanısı konulan, 20’li yaşlardaki kadın hastanın 10 yıllık takip süreci ayrıntılı olarak değerlendirilmektedir. Hasta, ağız kokusu, diş eti kanaması ve çiğneme güçlüğü gibi şikayetlerle kliniğe başvurmuştur. Önceden merkezlerde dişlerinin çekimi uygun görülmüştür. Yapılan klinik ve radyografik değerlendirmeler sonucunda alveoler kemik kaybı ve inflamasyon, tespit edilmiştir. Vakada cerrahi olmayan periodontal tedavi sonrasında, kemik grefti ve mine matriks proteini (Straumann® Emdogain®) uygulamalarını içeren rejeneratif cerrahi yaklaşımlar gerçekleştirilmiş ve uzun dönem idame tedavi protokolü sürdürülmüştür. Takip sürecinde yalnızca bir diş kaybı gözlenmiş olup, bu kaybın, hastanın tedaviye geçici olarak ara verdiği dönemde başka bir merkezde yapılan müdahalelerle ilişkili olduğu belirlenmiştir. On yıllık takip sonucunda, periodontal dokuların stabil kaldığı, inflamasyonun kontrol altına alındığı ve fonksiyonel bütünlüğün korunduğu saptanmıştır. Bu olgu, erken tanı, uygun tedavi planlaması ve düzenli idame bakımının, agresif periodontitis olgularında uzun dönem başarı için belirleyici unsurlar olduğunu göstermektedir.

Anahtar Kelimeler

• Agresif periodontitis
• rejeneratif periodontal cerrahi
• uzun dönem takip
• Stage III Grade C periodontitis.

Stage III Grade C Periodontitis: Long-Term Success with a 10-Year Maintenance Protocol: A Case Report

Öz

Introduction: Aggressive periodontitis, defined as a rapidly progressive periodontal disease in the 1999 classification, has been recategorized in the new classification system adopted at the 2017 World Periodontics Workshop. This new perspective aims to evaluate the risk profile of severe periodontal destruction, and to improve prognosis. Objective: This case report aims to evaluate the 10-year clinical outcomes of a long-term maintenance protocol for periodontal treatment in a 23-year-old woman diagnosed with Stage III, Grade C periodontitis. Materials and Methods: The patient presented to our clinic with complaints of halitozis, gingival bleeding, and difficulty chewing. Multiple tooth extractions were recommended at previous clinics. Clinical and radiographic evaluations performed at our clinic revealed significant alveolar bone loss and severe inflammation. Treatment was initiated with a nonsurgical periodontal approach that included oral hygiene motivation, tooth surface debridement, and root surface debridement. Regenerative periodontal surgery, including bone grafting and enamel matrix protein (Straumann®️ Emdogain®️), was subsequently performed, and the patient was enrolled in a risk-based, structured maintenance program. Results: During the 10-year follow-up period, only one tooth was lost. This loss was determined to be related to interventions performed at another center during the patient's temporary treatment interruption. Regular follow-up examinations revealed that the periodontal tissues remained stable, inflammation was controlled, and functional integrity was maintained. Discussion: This case demonstrates that despite advanced tissue loss at a young age, teeth can be preserved long-term with proper treatment planning, regenerative approaches, and high patient compliance. Furthermore, the maintenance phase is critical and could negatively impact clinical stability if interrupted. Conclusion and Recommendations: Early diagnosis, personalized treatment planning, and regular follow-up are key determinants of long-term success in cases of Stage III and Grade C periodontitis. In similar cases, close monitoring of patient compliance and frequent maintenance intervals based on risk profile are recommended.

Anahtar Kelimeler

• Aggressive periodontitis
• regenerative periodontal surgery
• long-term follow-up
• Stage III Grade C periodontitis.

Kaynakça

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