Entire Papilla Preservation and Conventional Flap Surgery in Treating Intrabony Defects: A 6-Month Clinical Trial

Necmettin Erbakan University

Status: Active, not recruiting

Conditions: Periodontal Intrabony Defect

Treatments: Procedure: Entire Papilla Preservation Technique; Procedure: Conventional Flap Surgery Technique

Study type: Observational

Funder types: Other

Identifiers

NCT06687785

20576

Details and patient eligibility

About

Intraosseous defects are characterized by vertical bone loss within the borders of the alveolar bone surrounding the teeth due to periodontal disease and are considered a clinically concerning condition. Treatment of intraosseous defects involves regenerative techniques aimed at reconstructing lost periodontal structures (including bone, cementum and periodontal ligament). In the process of periodontal regeneration, it is of great importance that the blood clot attached to the root surface is protected from mechanical and microbiological factors and remains in a stable biological environment. Post-surgical wound dehiscence can lead to impaired clot stabilization and infection, negatively affecting the healing process and thus jeopardizing the results of the treatment.

Regenerative therapies using conventional flap surgery have been reported to provide significant improvements in clinical attachment levels, but carry a high risk of loss of attachment if flap management is inadequate. Furthermore, complications such as difficulty in primary closure, risk of membrane exposure and tissue detachment have been observed with conventional flap techniques. Various minimally invasive flap surgery techniques have been developed to prevent these complications. One of the minimally invasive periodontal flap techniques is the full papillary preservation technique. Unlike traditional methods, this innovative approach provides vertical access to the defect area from the buccal and lingual adjacent areas without any incision in the papillary region. This technique reduces the risk of wound healing failure and exposure of regenerative biomaterials due to the fully preserved interdental papilla over the bony defect. The aim of our study is to compare the short-term (6 months) radiographic and clinical results of the Entire Papilla Preservation (EPP) technique with the Conventional Flap Surgery (CFS) technique.

Enrollment: 28 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Systemic health
• Probing depth (PD) ≥7 mm
• Clinical attachment level (CAL) ≥7 mm
• Presence of an isolated two or three walled intraosseous defect with an intraosseous component of at least 4 mm predominantly involving the interproximal region of the affected tooth
• Full mouth plaque score (FMPS) and full mouth bleeding score ≤20%

Exclusion criteria

• Current smoking habit
• Presence of uncontrolled systemic diseases that prevent periodontal surgery
• Use of drugs that affect periodontal tissues
• Pregnancy and breastfeeding
• Single-walled intraosseous defects
• Defects involving the buccal and/or lingual areas of the tooth
• Inadequate endodontic treatment and/or restorations on teeth in the defect area.

Trial design

28 participants in 2 patient groups

Entire Papilla Preservation Technique

Description:

The Entire Papilla Preservation Technique (EPP) is a novel surgical approach aimed at enhancing periodontal regeneration, particularly in the treatment of deep intrabony defects. This technique is characterized by its focus on preserving the entire interdental papilla, which is crucial for both functional and aesthetic outcomes in periodontal therapy. The EPP technique involves creating a tunnel-like undermining incision that allows access to the defect while maintaining the integrity of the papilla, thereby minimizing trauma to the surrounding soft tissues

Treatment:

Procedure: Entire Papilla Preservation Technique

Conventional Flap Surgery

Description:

In periodontology, the traditional flap surgery technique is a well-established surgical approach used for the treatment of periodontal diseases, especially in cases with deep periodontal pockets. This technique involves the lifting of a mucoperiosteal flap in the buccal and lingual direction to gain access to the underlying periodontal tissues and allows for thorough debridement of root surfaces and removal of diseased tissue.

Treatment:

Procedure: Conventional Flap Surgery Technique