Non-surgical periodontal therapy in treating stage III, grade C molar incisor pattern periodontitis among juvenile patients: A Case Series

Min (Sherry) Yang

Mohammad Abu Kar

Yucheng Chang

Yang, Min (Sherry), Abu Kar, Mohammad, Chang, Yucheng
University of Pennsylvania School of Dental Medicine, Department of Orthodontics; Department of Periodontics


Stage III Grade C molar incisor pattern (MIP) periodontitis treatment presents as a challenge due to its early onset and rapid progression. The severe attachment loss, supra and sub-crestal defect create tremendous difficulties in gaining access for proper scaling and root planning. Oftentimes, surgical therapy was the default option in treating Stage III Grade C molar incisor pattern periodontitis. However, the surgical approach may not be available for many patients due to the consideration of age, finance and other factors. This case series presents the possibility of treating Stage III Grade C MIP periodontitis by non-surgical approach and maintaining a stable periodontium.


Two juvenile patients diagnosed with stage III, grade C molar incisor pattern periodontitis were treated in Penn Dental Medicine Grad Perio clinic. The active treatment time ranges between 1-2 months. The treatment protocol includes comprehensive scaling and root planning, adjunctive systemic antibiotics, and meticulous OHI. Patients were recalled at 6 weeks, 9 weeks, 3 months, 6 months, 12 months, and 18 months for maintenance.


Despite the sever inflammation and clinical attachment loss. The presentation of the soft tissue of two patients at the latest visit was pink, firm, well-adapted, and probing depths at the treated sites were less than or equal to 4 mm with absence of bleeding on probing (BOP). Moreover, the treated molar and incisor sites achieved clinical attachment gain and the evidence of the bone regeneration was noticed through radiographic examination.


This case series demonstrated the possibility to successfully treat Stage III Grade C molar incisor pattern periodontitis with non-surgical periodontal therapy along with adjunctive systemic antibiotics. The key of treating success may be contributed by early intervention, biofilm control by comprehensive Periodontal phase I treatment with rigid maintenance interval.