Successful long-term management of molars having advanced periodontal disease with secondary endodontic involvement is a challenge to the periodontist. Several treatment options exist for the periodontist based upon various factors. A patient with a deep periodontal pocket on the right mandibular first molar reported for dental treatment. Periapical radiographs revealed bone loss extending to the apex of the mesial root. The treatment plan included scaling, root planing, endodontic therapy and periodontal surgery for the involved tooth. During periodontal surgery, resective and regenerative treatment options were evaluated and explained to the patient. Considering the prognosis of the case, risk-benefit ratio and the patient's choice, regenerative periodontal therapy was performed. The case has been followed for two years, with gain in clinical attachment and radibgraphic bone fill. The authors discuss factors to be considered when choosing regenerative periodontal therapy over resective periodontal therapy.
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