FMTRadiographic Results

The biggest practical difficulties in any type of periodontitis therapy include, of course, deep pockets, roots with unusual morphology, limited physical access, poor visibility or none whatever, etc.

The most frequently encountered and most difficult problems, especially with closed treatment, include:

•  Deep and narrow bony pockets

•  Furcation involvement in multirooted teeth

•  The distal pocket following third molar extraction.

The potential of “full mouth therapy” was tested in precisely these difficult situations. In the radiographs below, “bone fill” is demonstrated that is seldom achieved with conventional closed therapy, or even with “access surgery” (p.300).

Bone fill does not, of course, reveal anything about true, effective histologic healing. On the other hand, bone fill never occurs in the vicinity of an active pocket! It is a testament to the dental hygiene profession that the cases depicted below were treated by students in a dental hygiene school!

653 Single-Rooted,

Vital Premolar with Large Vertical Osseous Defects— Initial Situation (left)

Right: Five months after initiation of treatment (hygiene phase) and subsequent FMT with “full mouth disinfection” the osseous defect has regenerated almost completely.

Antiseptics used during the active FMT: Combined irrigations with H2O2 mixed 1:1 with betadine.

FMT / FMD—Single-Rooted Tooth

654 Molar 36 with a Distal Bony Defect and Severe Furcation Involvement—

Initial Situation (left)

Right: Radiographic view two years later. The hygiene phase included removal of restoration overhangs, polishing as well as closed mechanical therapy/FMT. Note the almost complete osseous regeneration in the furcation.

FMT / FMD—Severe Furcation Involvement (F2)

655 Distal Pocket Following Third Molar Extraction—

Initial Situation (left)

Massive bone loss and an unfavorable open area (anatomic defects) for any future bone regeneration.

Right: Radiographic view two years later. The bone has regenerated, leaving only a small residual defect. The probing depth at this site was 4 mm.

FMT / FMD—Distal Pocket after Third Molar Extraction

Courtesy U. Saxer

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