A patient presented with an infra-bony defect on the vestibular side at position 2.3. Initial probing depth was 7-8 mm. Even if only one bone wall could provide blood supply, bone regeneration had to be attempted in order to diminish the risk of an aesthetic failure. After debridement of granulation tissue, the defect was grafted with an enzyme-deantigenic, collagen preserved, equine-derived bone substitutes, and covered with an equine pericardium membrane.
The healing of soft tissues continued until complete recovery at 90 days, showing no gingival recession. Probing depth, still at 90 days, was only 1-2 mm.
The way we managed this challenging infra-bony defect has allowed to give a good recover of gingival health and a satisfying aesthetic outcome. These results suggest that enzyme-deantigenic collagen preserved, bone substitutes could be used successfully even in the presence of particularly challenging infra-bony defects.
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