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Regenerative Periodontal Surgery — ORE Part 1 MCQ

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HardPeriodontologyRegenerative Periodontal SurgeryORE Part 1

A 45-year-old patient has completed cause-related periodontal therapy and demonstrates good plaque control. A lower molar has a persistent isolated 10 mm mesial probing pocket; all other sites are 4 mm or less. Radiography shows a deep, narrow intrabony defect adjacent to the mesial root. The tooth is vital, restorable and not mobile. Which surgical approach is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Regenerative flap surgery with GTR

Explanation lettering: E = shown as A · A = shown as C · C = shown as D · D = shown as E

A is correct. The residual 10 mm pocket is associated with a deep, narrow intrabony defect in a maintainable tooth after initial therapy. This morphology is favourable for regenerative surgery, and GTR has shown greater attachment gain and probing-depth reduction than open flap debridement for infrabony defects. Graft material may be added according to defect configuration, but it is not essential to the answer. B is a reasonable access procedure but is less appropriate where regeneration is feasible. C and D are resective options and would tend to sacrifice soft tissue and increase recession rather than regenerate lost attachment. E is inappropriate because the tooth is vital, restorable and non-mobile, with no stated hopeless prognostic factor.

Reference: Needleman IG, Giedrys-Leeper E, Tucker RJ, Worthington HV. Guided tissue regeneration for periodontal infra-bony defects. Cochrane Database of Systematic Reviews, 2001; updated 2006 and 2019. https://pubmed.ncbi.nlm.nih.gov/11406001/