In the treatment of Class II furcation defects, guided tissue regeneration (GTR) in combination with bone grafts has provided better treatment outcomes in comparison to GTR alone. A 48-year-old male patient reported with a chief complaint of pain and bleeding in the right lower back teeth area from 3 months. On clinical and radiographic evaluation, a Class II buccal furcation defect was detected in tooth #46. A bidirectionally positioned flap (BPF) technique in combination with bone graft was done to treat the defect following nonsurgical therapy. The healing was satisfactory postoperatively. The patient was recalled for supportive periodontal therapy at 3, 6, and 12 months. Clinical and radiographic outcomes after 12 months revealed possible new attachment and stable periodontal status. It is concluded that inner periosteal flap in BPF technique may serve as an alternative technique to GTR barrier membranes in case of Class II furcation defects.
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