Lingual plate regeneration through non-surgical VISUAL-SRP and laser bacterial reduction

51 year old, healthy male presented with class II - III mobile #8. Periodontal depths measured 10+ mm across the lingual and the radiograph implied lingual plate damage and potential complete loss. Treatment plan was to extract with an attempt to regenerate bone that would require extensive bone grafting. As a first step, #8 was included in non-surgical treatment with the magnified sub-gingival visualization of a periodontal endoscope. Clinical steps were 1.piezo debridement with 10%. iodine irrigation, 2. biofilm reduction with glycine powder through an air polisher, 3. debridement of root structure with VISUAL-SRP, 4. laser bacterial reduction with Nd:Yag, 5. Occlusal adjustment. At 3 months post procedure, bone regeneration was evident on the radiograph and the periodontal depths eliminated. At this time extraction is not indicated.