Long-term stability after non-surgical furcation retreatment with adjunctive collagen hydrogel

Background: Management of inflammation at previously surgically treated peri-
odontal sites represents a clinical challenge. Although surgical retreatment may
be indicated in selected cases, a conservative non-surgical approach may restore
periodontal stability while avoiding the additional morbidity associated with
repeated surgery. This case report describes the long-term management of a
previously surgically treated mandibular molar furcation using site-specific non-
surgical retreatment combined with adjunctive application of a collagen-based
hydrogel.
Methods: A 45-year-old non-smoking male with a history of stage III, grade B peri-
odontitis presented with persistent inflammation at a previously surgically treated
mandibular first molar. Clinical examination revealed a 4-mm mid-buccal probing
depth associated with bleeding on probing and Grade II furcation involve-
ment. Following comprehensive periodontal re-evaluation, the site was managed
by meticulous non-surgical re-instrumentation and adjunctive application of a
collagen-based hydrogel as a conservative alternative before considering surgi-
cal re-intervention. The patient was subsequently enrolled in an individualized
supportive periodontal care program.
Results: Bleeding on probing resolved within 25 days and remained absent
throughout the 6-year follow-up. Probing depth progressively decreased from 4 to
2 mm, while the previously inflamed furcation site became clinically stable and
maintainable without requiring additional periodontal surgery.
Conclusions: Within the limitations of a single case report, this case illustrates that
a carefully executed conservative retreatment strategy, combining meticulous
non-surgical periodontal therapy, individualized supportive periodontal care, and
adjunctive collagen hydrogel application, may successfully restore and maintain
periodontal stability at a previously surgically treated furcation site while avoid-
ing surgical re-intervention. Controlled prospective studies are required to clarify
the clinical contribution of adjunctive collagen hydrogels in the management of
persistent periodontal defects.

PRODUCT USED: H42