A case of generalized chronic periodontitis that improved with initial periodontal therapy alone

: This is a case report of generalized severe chronic periodontitis that was treated by initial periodontal therapy alone. The patient was a 42-year-old female who had been referred to our clinic three months earlier with the chief complaint of gingival redness, swelling and bleeding. Clinical observation revealed generalized gingival redness and swelling, especially, inflammatory gingival hyperplasia on the left maxillary alveolar ridge. Clinical examination revealed 31.9% bleeding on probing (BOP), 52.1% periodontal pocket probing depth (PPD) ＞4 mm, and 50% OʼLearyʼs plaque control record (PCR). Radiographic examination showed a localized vertical bone defect in the anterior mandible and some defects in the posterior mandible. After explaining the results of the periodontal tissue examination and providing repeated oral hygiene instructions, scaling and root planing were performed. To keep the patient motivated, we confirmed the possible prolonged treatment course and patient background with her and ensured that she fully under-stood her oral condition. As the initial therapy progressed, the oral hygiene improved, with disappearance of the gingival swelling. At the re-evaluation, we confirmed the improvement of the alveolar bone defect on the radiographs, so that we could proceed to prosthodontic treatment without any need for periodontal surgery. After com-pletion of the restorative therapy, we started the patient on supportive periodontal therapy in Septem-ber 2015.