Double‐sided entire papilla preservation for mandibular distal furcation defect: A case report

Abstract Background Distal furcation‐associated intrabony defects in mandibular molars are difficult to manage because of limited surgical access, restricted visibility, and complex root anatomy. This case report describes the regenerative management of a distal furcation‐associated intrabony defect in a mandibular first molar using recombinant human fibroblast growth factor‐2 (rhFGF‐2) with a double‐sided entire papilla preservation technique‐based approach (DEPPT‐BA). Methods A 56‐year‐old systemically healthy woman presented with stage III, grade B periodontitis and Hamp Class II distal furcation involvement of the mandibular left first molar, with a maximum probing pocket depth (PPD) of 8 mm. After initial periodontal and endodontic therapy, periodontal regenerative surgery was performed using the DEPPT‐BA to obtain buccal and lingual access while preserving the interdental papilla. rhFGF‐2 was applied to the defect without adjunctive bone graft material. Results Healing progressed without major complications. At 12 months postoperatively, PPDs were ≤2 mm at all sites, bleeding on probing was absent, and the distal furcation involvement was clinically resolved without gingival recession. Cone‐beam computed tomography demonstrated substantial bone fill within the intrabony defect and clinical resolution of the distal furcation involvement. Conclusions Within the limitations of a single case report, this application of DEPPT‐BA combined with rhFGF‐2 may improve buccal and lingual access while maintaining interdental soft‐tissue stability in distal furcation‐associated intrabony defects with buccolingual extension in mandibular molars. Key points Distal furcation‐associated intrabony defects in mandibular molars pose considerable regenerative challenges, given limited access, restricted visibility, and complex root anatomy. DEPPT‐BA provided buccal and lingual access to the distal furcation defect while preserving the interdental papilla and maintaining wound stability. Favorable 12‐month clinical and radiographic outcomes were achieved using rhFGF‐2 without adjunctive bone grafting material. Plain language summary This case report describes the treatment of a difficult periodontal defect affecting the distal furcation area of a mandibular molar using DEPPT with rhFGF‐2. The technique improved surgical access while maintaining soft‐tissue stability, resulting in favorable clinical healing and substantial bone fill at 12 months.