Placing Periodontal Fibers in a Periodontally Compromised Patient

 

Periodontal Fibers in a Periodontally Compromised Patient

In patients with periodontal compromise, the natural periodontal ligament and its fibers are often destroyed due to chronic inflammation, bone loss, or trauma. Restoring the lost periodontal support involves regenerative periodontal therapy and strategic placement of biomimetic materials that promote healing and new attachment formation.

Clinical Considerations:

1. Assessment of Periodontal Status

   • Evaluate clinical attachment loss, pocket depth, mobility, and bone levels.

   • Radiographs and probing are essential for diagnosis and treatment planning.

2. Initial Therapy (Phase I)

   • Scaling and root planing to reduce bacterial load and inflammation.

   • Patient education and reinforcement of oral hygiene.

3. Surgical Intervention (Phase II)

   • Guided Tissue Regeneration (GTR) is the preferred method to promote the reformation of periodontal fibers.

   • Use of resorbable or non-resorbable membranes to guide the growth of new PDL, cementum, and alveolar bone.

   • Placement of bone grafts (autograft, allograft, xenograft, or synthetic) to fill osseous defects.

4. Placement of PDL-Like Materials

   • While true periodontal fibers cannot be directly “placed,” regenerative procedures aim to stimulate the reformation of new Sharpey’s fibers into newly formed cementum and bone.

   • Biomaterials such as enamel matrix derivatives (EMD, e.g., Emdogain) or PDGF-BB (platelet-derived growth factor) are used to encourage the regeneration of the PDL.

   • Ensure root biomodification (e.g., tetracycline conditioning) to enhance new attachment formation.

5. Postoperative Protocol

   • Antibiotics, chlorhexidine rinse, and strict plaque control.

   • Periodic recall and monitoring of healing, pocket depth reduction, and tooth stability.

• Conclusion

Direct placement of periodontal fibers is not possible, but through regenerative periodontal therapies, it is feasible to stimulate the body to regenerate PDL fibers. Success depends on meticulous case selection, precise surgical technique, and post-op care.

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Call us at: +912240147049/09321330133
iDent, Idyll Dental Clinic
Email: smileident@gmail.com
Website: www.smileident.com