• Biljana Evrosimovska Deparment of oral Surgery and Implantology, University Dental Clinical Center St Pantelejmon, Skopje, Faculty of Dentistry, Ss Cyril and Methodius University in Skopje, R.North Macedonia
  • Ivana Pop Janeva Private Practice PopJanevi- Skopje, R.North Macedonia
  • Bojana PopJaneva Private Practice PopJanevi- Skopje, R.North Macedonia
  • Bruno Nikolovski Clinic for Oral Surgery and Implantology, University dental clinical center St. Pantelejmon in Skopje, R. North Macedonia


Periodontal disease is defined as a complex, multifactorial disease characterized by the loss of connective tissue attachment with destruction of periodontal tissues. The aim of periodontal therapy is to eliminate inflammatory process, prevent the progression of periodontal disease and also to regenerate the lost of periodontal tissues. Loss of the bone support by creating a periodontal pocket is one of the most common cause of tooth extraction. Their treatment can be conservative and surgical. The purpose of this paper is to demonstrate the treatment of infrabony  periodontal defects  with bone and soft tissue regeneration. On periodontal examination and radiographic evaluation, the female 56-year-old patient presented with an infrabony defect extending up to apical third of the mesial side of the right maxillary second molar with a probing depth of 8 mm. After conservative periodontal treatment, oral surgical intervention was performed including open flap debridement and filling the defect with xenograft and plasma rich fibrin. The application of xenograft and Plasma rich fibrin resulted in bone regeneration of the defect and successful fixed prosthodontic solution. Guided bone and soft tissue regeneration using xenograft and fibrin-rich plasma gives successful radiological and clinical signs of bone augmentation and consolidation of defects caused by loss of tooth attachment.

Keywords: periodontal pocket, xenograft, PRF.




1. EF Corbet,DKL Ho, Radiographs in periodontal disease diagnosis and managementFirst published: 03 September 2009 https://doi.org/10.1111/j.1834-7819.2009.01141.x Citations: 38.
2 .Del Fabbro M, Karanxha L, Saurav P, Bucchi C, Doraiswamy J N, Sankari M, Ramamoorthi S, Varghese S, Taschieri S. Autologous platelet concentrates for treating periodontal infrabony defects. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: CD011423. doi: 10.1002/14651858.CD011423.
3. Andrea Pilloni, Mariana A. Rojas, Lorenzo Marini, Paola Russo, Yoshinori Shirakata, Anton Sculean,3 and Roberta Iacono1 : Healing of intrabony defects following regenerative surgery by means of single-flap approach in conjunction with either hyaluronic acid or an enamel matrix derivative: a 24-month randomized controlled clinical trial;Published online 2021 Feb 10. doi: 10.1007/s00784-021-03822-x.
4. Preeja C, Arun S Platelet-rich fibrin: Its role in periodontal regeneration, King Saud University Journal of Dental Sciences (2013), http://dx.doi.org/10.1016/j.ksujds.2013.09.001.
5. Balaram Naik, P Karunakar, M Jayadev, and V Rahul Marshal : Role of Platelet rich fibrin in wound healing: A critical review ; J Conserv Dent. 2013 Jul-Aug; 16(4): 284–293.doi: 10.4103/0972-0707.114344.
6. Yongping Yuan, Jiajia Zhao, and Nv He .Observation on the Effect of Bone Grafting Alone and Guided Tissue Regeneration Combined with Bone Grafting to Repair Periodontal Intraosseous Defects ; Evid Based Complement Alternat Med. 2021; 2021: 1743677.
Published online 2021 Oct 12. doi: 10.1155/2021/1743677
7. M. Siaili, D. Chatzopoulou, and D.G. Gillam⁎ An overview of periodontal regenerative procedures for the general dental practitioner ; Saudi Dent J. 2018 Jan; 30(1): 26–37.
Published online 2017 Nov 14. doi: 10.1016/j.sdentj.2017.11.001.
8. N.H. Hart, S. Nimphius, T. Rantalainen, A. Ireland,A. Siafarikas, and R.U. Newton1: Mechanical basis of bone strength: influence of bone material, bone structure and muscle action;J Musculoskelet Neuronal Interact. 2017 Sep; 17(3): 114–139.
9. Petsos H., Ratka‐Krüger P., Neukranz E., Raetzke P., Eickholz P., Nickles K. Infrabony defects 20 years after open flap debridement and guided tissue regeneration. Journal of Clinical Periodontology . 2019;46(5):552–563. doi: 10.1111/jcpe.13110. [PubMed] [CrossRef] [Google Scholar].
10. Geão C., Costa-Pinto A. R., Cunha-Reis C., et al. Thermal annealed silk fibroin membranes for periodontal guided tissue regeneration. Journal of Materials Science: Materials in Medicine . 2019;30(2):p. 27. doi: 10.1007/s10856-019-6225-y. [PubMed] [CrossRef] [Google Scholar].
11. Lekovic V, Camargo PM, Weinlaender M, Nedic M, Aleksic Z, Kenney EB. A comparison between enamel matrix proteins used alone or in combination with bovine porous bone mineral in the treatment of intrabony periodontal defects in humans. J Periodontol. 2000; 71:1110–6.
12. Tatullo M, Marrelli M, Cassetta M, Pacifici A, Stefanelli LV, Scacco S, et al. Platelet Rich Fibrin in reconstructive surgery of atrophied maxillary bones: Clinical and histological evaluations. Int J Med Sci. 2012;9:872–80.
How to Cite
EVROSIMOVSKA, Biljana et al. ORAL-SYRGICAL TREATMENT OF PERIODONTAL POCKET WITH GUIDED BONE AND SOFT TISSUE REGENERATION. Journal of Morphological Sciences, [S.l.], v. 5, n. 1, p. 179-186, may 2022. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/vol5no1-24>. Date accessed: 03 dec. 2022.