In the following operation Prof. Wachtel, Munich/Germany, restores a deep three-walled periodontal defect of the lower right lateral incisor. A buccal and lingual full thickness flap is prepared by a sulcular incision. An additional vertical 45 degree releasing incision is performed distal of the lower right second molar. Care has to be taken not to hit the alveolar nerve. After cleaning the periodontal defects using root planning, diamond ultrasonic tips and EDTA the defects are cleaned using cotton gauzes.
This is done in order to let the Emdogain touch the root surface first, instead of blood. After decorticating the bone of the defects a mixture of allogenic and allogenous bone from the linea obliqua fills the defects. A BioGuide collagen membrane is placed on top augmentation and closing the wound is performed with double sling sutures to ensure primary healing.