Dr. John Turner- Grand Rounds Cases
Study Club conversation regarding these cases:
Case 1: Chronically inflamed pockets with probing depths 5-6. Maintain as best as possible with perio maintenance and focus on decreasing bop. If bop not resolved in 6mm pockets, it is reasonable to think about osseous surgery.
Case 2: One area with 7mm pocket that isn't resolving. Possible open flap debridement. When flap is open, assess if anatomy could be changed to be more favorable. This would probably be done by adding a little bone with no membrane.
Case 3: Traumatic occlusion and mobility. This is tough. Maybe splinting? But yeah- with that occlusion, it's going to be tough.
Case 4: A 3mm pocket became a 6mm pocket over 6 months. It's probably due to subgingival calculus. SRP. Once things resolve, think about grafting back the lost tissue.
Case 5: Deep (8mm) probing depth distal to 2nd molars. Consensus to leave it alone. Especially on lower. On upper, distal wedge procedure could be done, but this is technically difficult and benefits/risks should be carefully weighed.
Case 6: Tooth being ext. prior to ortho. No graft is needed. No indication to wait before initiation of ortho.