Abstract: Periodontitis is one of the most common causes of tooth loss，which adversely affects oral health and increases risk of suffering from some kind of systemic disease. The treatment goals of periodontal therapy involve periodontal inflammation elimination and disease progression termination，thus restoring oral function and aesthetics. In order to achieve these aims，clinicians should firstly proceed detailed periodontal examination and formulate proper treatment plan. To preserve natural teeth with advanced periodontal destruction，and maintain their function is a challenge to dentists. This article presented the comprehensive treatment process of a patient diagnosed with advanced periodontitis. By thorough periodontal initial therapy and proper periodontal surgery，inflammation was successfully controlled. Furthermore，removable partial denture was applied to replace the lost teeth and restore oral function. In the course of active periodontal treatment and afterwards，periodontal maintenance therapy was regularly performed. In the subsequent 6-year follow-up，a good therapeutic effect was observed. This article focused on treatment decision-making for patients with advanced periodontitis，and discussed the clinical efficacy of initial and surgical therapy on advanced periodontitis. Moreover，it also emphasized the importance of patient′s daily plaque control in regular professional maintenance therapy，which provided clinical experience for management of advanced periodontitis.

Key words: periodontal initial therapy, periodontal surgery, guided tissue regeneration, patient compliance, plaque control

摘要： 牙周炎是最常见的失牙原因之一，不仅严重影响口腔健康，也是多种全身性疾病的风险因素。完善的牙周检查及系统的治疗计划是消除炎症、控制疾病进展、恢复口腔功能和美观的关键。如何尽最大可能保留存在牙周组织严重破坏的天然牙并维持其功能是口腔医生面临的挑战。文章展示了1例重度牙周炎病例的综合诊疗过程，通过完善的牙周基础治疗和恰当的手术治疗，控制了牙周炎症进展，并采用可摘局部义齿修复缺失牙，恢复口腔功能，同时定期行牙周维护治疗，随访6年，获得良好的治疗效果。基于此病例，文章探讨了重度牙周炎患牙的治疗决策，重度牙周炎诊疗中基础治疗和手术治疗的临床效果以及菌斑控制对长期维护治疗效果的作用，总结了本病例临床处理中的不足，为重度牙周炎的治疗积累了经验。

关键词: 牙周基础治疗, 牙周手术, 引导性组织再生术, 患者依从性, 菌斑控制