Management of generalized stage III grade C periodontitis with extracoronal wire splinting and gingival curettage: A case report

Abstract

Periodontitis is an inflammatory disease of the periodontal tissues that leads to attachment loss and tooth mobility, thus requiring comprehensive management. Periodontal therapy is initiated with non-surgical treatment aimed at controlling bacterial infection, reducing inflammation, and preventing the progression of periodontal tissue destruction through scaling and root planing. Teeth with mobility can be managed with extracoronal splinting to improve stability, while persistent inflammation within periodontal pockets may require curettage as a surgical therapy to eliminate granulation tissue. A 42-year-old female presented with complaints of mobility in the mandibular anterior teeth and gingival recession. Clinical examination revealed grade 1–2 tooth mobility, probing depths of 1–5 mm, positive bleeding on probing, and clinical attachment loss of 3–8 mm. Radiographic examination showed that there was alveolar bone resorption that extended to the middle 1/3 of the root. The diagnosis was established as generalized periodontitis stage III grade C based on the greatest interdental CAL of 8 mm on tooth 31, alveolar bone resorption up to the middle third of the root, and the bone loss percentage to age ratio of 50%/42 years, which is 1.19 (>1.0), according to the 2018 periodontal disease classification criteria. Treatment was performed in stages, including scaling and root planing, followed by extracoronal wire splinting on teeth 33–43 for stabilization, and periodontal curettage to eliminate residual inflamed tissue. Evaluation at 1 month showed reduced tooth mobility, improvement in gingival condition, and reduction in probing depth to 1–3 mm. A staged treatment approach for Stage III Grade C periodontitis in this case demonstrated short-term clinical improvement, although long-term follow-up is required to evaluate the stability of treatment outcomes.