{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:12Z","timestamp":1786121352906,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Periodontal regenerative therapy using recombinant human fibroblast growth factor\u20102 (rhFGF\u20102) combined with deproteinized bovine bone mineral (DBBM) has demonstrated favorable and predictable clinical outcomes for intrabony defects. However, long\u2010term outcomes and potential challenges following such combination therapies remain poorly documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 40\u2010year\u2010old woman with generalized stage III grade C periodontitis underwent periodontal regenerative therapy using rhFGF\u20102 combined with DBBM for a one\u2010wall defect at the mandibular left first molar (#19).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Favorable periodontal healing was maintained for approximately 4 years. However, for tooth #19, the probing depth gradually increased at 5 years 2 months post\u2010surgery, and the patient developed discomfort and pulpal symptoms by 6 years 2 months. Clinical examination revealed an agglomerate of DBBM particles and a palpable external root resorption lesion. The tooth was extracted due to irreversible pulpal involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates that despite favorable early healing, periodontal regenerative therapy may lead to rare late\u2010onset complications such as external root resorption. Long\u2010term follow\u2010up and careful consideration of biomaterial interactions are essential when employing combination regenerative approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Periodontal regenerative therapy using rhFGF\u20102 and DBBM achieved favorable clinical outcomes for 4 years before unexpected late\u2010onset external root resorption developed.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Long\u2010term persistence and partial separation of DBBM particles, along with the response of macrophage\u2010 or osteoclast\u2010lineage cells, are associated with a potential for delayed resorptive pathology on adjacent root surfaces.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Clinicians should recognize the possibility of late complications and carefully consider biomaterial interactions when selecting regenerative strategies and informing patients.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cap.70083","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:39:44Z","timestamp":1786077584000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Late\u2010onset external root resorption following periodontal regenerative therapy using rhFGF\u20102 and DBBM: A case report"],"prefix":"10.1002","author":[{"given":"Yoshimi","family":"Saito","sequence":"first","affiliation":[{"name":"Department of Periodontology Tokyo Dental College  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Imamura","sequence":"additional","affiliation":[{"name":"Department of Periodontology Tokyo Dental College  Tokyo Japan"},{"name":"Oral Health Science Center Tokyo Dental College  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayuri","family":"Ambiru","sequence":"additional","affiliation":[{"name":"Department of Periodontology Tokyo Dental College  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideto","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Periodontology Tokyo Dental College  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Nikaido","sequence":"additional","affiliation":[{"name":"Department of Periodontology Tokyo Dental College  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0065-2207","authenticated-orcid":false,"given":"Atsushi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Periodontology Tokyo Dental College  Tokyo Japan"},{"name":"Oral Health Science Center Tokyo Dental College  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/j.1600-051X.1986.tb00854.x","article-title":"New attachment formation in the human periodontium by guided tissue regeneration. 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