The primary objective of the present study is to clinically and radiographically evaluate nonincised papillae surgical approach and entire papilla preservation approach for the treatment of intrabony defects with GTR membrane and hydroxyapatite graft.
Various procedures to treat intrabony defects by preserving the interdental papilla include conventional, simplified, and modified papilla preservation techniques. The drawback of these techniques is the post-surgical gingival recession. In order to overcome this drawback, the "entire papilla preservation" technique has been proposed, by preserving the whole integrity of the defect associated papilla providing a tunnel-like undermining incision. Recently a novel surgical procedure, termed nonincised papillae surgical approach (NIPSA), was designed to maintain the integrity of the interdental soft tissues covering intrabony defects. This would prevent biomaterial exposure associated with loss of papillary height, increase the amount of space for hard and soft tissue regeneration, and minimize gingival recession.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
34
The basic principle of the technique is the placement of only one buccal horizontal or oblique incision in the mucosa, as apically as possible from the periodontal defect and the marginal tissues, and the raising of a mucoperiosteal flap coronally, which permits apical access to the defect but leaving the marginal tissues intact, acting as a "dome" for the protection of the clot.
The entire Papilla Preservation Technique is to preserve the whole integrity of the defect- associated papilla providing a tunnel-like undermining incision. The completely preserved interdental papilla provides an intact gingival chamber to stabilize the blood clot and improve the wound healing process. To provide adequate access for debridement, EPP requires a short buccal vertical releasing incision on the buccal side of the neighboring tooth extending just beyond the mucogingival line.
R V Chandra
Hyderabad, Telangana, India
RECRUITINGCLINICAL ATTACHMENT LEVEL (CAL)
measured from the cemento-enamel junction (CEJ) to the bottom of the pocket
Time frame: Baseline to 6 months
POCKET PROBING DEPTH (PPD)
from the gingival margin to the bottom of the pocket;
Time frame: Baseline to 6 months
Intrabony component (INTRA) of the defect
the distance from the most coronal extension of the interdental bone crest (BC) to the bottom of the defect (BD) (BC-BD).
Time frame: Baseline to 6 months
Papilla loss (PL)
measured from contact point to tip of the papilla.
Time frame: Baseline to 6 months
Local bleeding score
recorded as positive when bleeding on probing was present at the surgical site.
Time frame: Baseline to 6 months
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