Periodontal Healing of a Human Intrabony Defect Treated by Autogenous Periosteal Barrier Membrane and Bone Graft: A Clinical and Histologic Case Report

Introduction: The aim of this case report is to clinically and histologically evaluate the healing of a deep intrabony defect treated with a combination therapy using autogenous periosteal membrane and autogenous bone graft. Case Presentation: A 45-year-old female was scheduled for hemisection of tooth #30, affected by a degree III furcation involvement, with the extraction of the mesial root. The root was associated with a 6-mm intrabony defect. The patient volunteered to have the defect treated by a regenerative technique before the extraction. A notch was placed at the level of the crestal bone on the root surface to serve as reference for histologic evaluation. The intrabony defect was filled by autogenous bone chips and covered by an autogenous periosteal barrier membrane obtained from the palate. One year after regenerative treatment, a block biopsy containing the root with some of the surrounding soft and hard tissues was sampled during the tooth hemisection procedure and processed for histologic evaluation. At the 12-month examination, a 7-mm probing depth decrease and a 4-mm clinical attachment gain were observed. The radiographic examination showed the complete filling of the defect. Histologic evaluation showed the formation of new cellular cementum with inserting collagen fibers from the base of the defect to the notch level. Newly formed bone was also observed. Conclusion: Our results suggest that the adjunctive use of autogenous bone graft and periosteal barrier membrane may represent a promising surgical technique for periodontal regeneration in clinical practice.