Entire Papilla Preservation and Conventional Flap Surgery in Treating Intrabony Defects: A 6-Month Clinical Trial
NCT ID: NCT06687785
Last Updated: 2024-12-27
Study Results
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Basic Information
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ACTIVE_NOT_RECRUITING
28 participants
OBSERVATIONAL
2024-07-26
2025-02-28
Brief Summary
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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.
Detailed Description
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Conditions
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Keywords
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Study Design
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CASE_CONTROL
RETROSPECTIVE
Study Groups
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Entire Papilla Preservation Technique
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
Entire Papilla Preservation Technique
A buccal intrasulcular incision was made in the tooth with the defect and a vertical incision was made extending from the buccal center of the tooth to the mesial papillary crest and crossing the mucogingival line. Then, using a micro periosteal elevator, a full-thickness mucoperiosteal flap was lifted from the incision site to the defect under the papilla. After removal of the granulation tissues in the area, bone graft was applied for regenerative purposes and the vertical incision was sutured with 6/0 polypropylene suture using simple suture technique.
Conventional Flap Surgery
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.
Conventional Flap Surgery Technique
After buccal and lingual intrasulcular incisions were made to eliminate the teeth and papillae adjacent to the defect, a full-thickness mucoperiosteal flap was raised in the vestibular and lingual direction with a periosteal elevator. After removal of the granulation tissues in the area, bone graft was applied for regenerative purposes and the papillary incisions were sutured with 5/0 polypropylene suture using simple suture technique.
Interventions
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Entire Papilla Preservation Technique
A buccal intrasulcular incision was made in the tooth with the defect and a vertical incision was made extending from the buccal center of the tooth to the mesial papillary crest and crossing the mucogingival line. Then, using a micro periosteal elevator, a full-thickness mucoperiosteal flap was lifted from the incision site to the defect under the papilla. After removal of the granulation tissues in the area, bone graft was applied for regenerative purposes and the vertical incision was sutured with 6/0 polypropylene suture using simple suture technique.
Conventional Flap Surgery Technique
After buccal and lingual intrasulcular incisions were made to eliminate the teeth and papillae adjacent to the defect, a full-thickness mucoperiosteal flap was raised in the vestibular and lingual direction with a periosteal elevator. After removal of the granulation tissues in the area, bone graft was applied for regenerative purposes and the papillary incisions were sutured with 5/0 polypropylene suture using simple suture technique.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* 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
* 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.
18 Years
65 Years
ALL
Yes
Sponsors
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Necmettin Erbakan University
OTHER
Responsible Party
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Fatma Uçan Yarkaç
Associate Professor, Dr.
Principal Investigators
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Fatma UCAN YARKAC, assoc. prof.
Role: PRINCIPAL_INVESTIGATOR
Necmettin Erbakan University
Locations
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Necmettin Erbakan University, Faculty of Dentistry
Konya, , Turkey (Türkiye)
Countries
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References
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Stavropoulos A, Karring T. Five-year results of guided tissue regeneration in combination with deproteinized bovine bone (Bio-Oss) in the treatment of intrabony periodontal defects: a case series report. Clin Oral Investig. 2005 Dec;9(4):271-7. doi: 10.1007/s00784-005-0002-7. Epub 2005 Jul 12.
Aslan S, Buduneli N, Cortellini P. Entire Papilla Preservation Technique: A Novel Surgical Approach for Regenerative Treatment of Deep and Wide Intrabony Defects. Int J Periodontics Restorative Dent. 2017 Mar/Apr;37(2):227-233. doi: 10.11607/prd.2584.
Yarkac FU, Yildiz K, Kalender ME, Ogutcen O. Clinical and radiographic outcomes of entire papilla preservation versus open flap debridement using bovine-derived xenograft and leukocyte- and platelet-rich fibrin in the treatment of isolated intrabony defects. BMC Oral Health. 2025 Oct 21;25(1):1639. doi: 10.1186/s12903-025-07008-9.
Other Identifiers
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20576
Identifier Type: -
Identifier Source: org_study_id