Single-flap versus double-flap approach for periodontal pocket reduction in supraosseous defects: a comparative study
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Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.
Abstract
Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.
참고문헌 (37)
- Stadler AF, "Tooth loss in patients under periodontal maintenance in a private practice : a retrospective study", Braz Dent J, 28, pp.440~446 (2017)
- McLeod DE, "The effectiveness of periodontal treatment as measured by tooth loss", J Am Dent Assoc, 128, pp.316~324 (1997)
- Caton JG, "The attachment between tooth and gingival tissues after periodic root planing and soft tissue curettage", J Periodontol, 50, pp.462~466 (1979)
- Caton J, "Histometric evaluation of periodontal surgery. II. Connective tissue attachment levels after four regenerative procedures", J Clin Periodontol, 7, pp.224~231 (1980)
- Barrington EP, "An overview of periodontal surgical procedures", J Periodontol, 52, pp.518~528 (1981)
- Suchetha A, "Post-operative complications after periodontal surgery", Int J Appl Dent Sci, 4, pp.152~156 (2018)
- Steffer MR, "Comparison of minimally invasive and conventional flap surgery for treatment of intrabony periodontal defects: a pilot case-controlled study", J Contemp Dent, 3, pp.61~67 (2013)
- Trombelli L, "Single-flap approach for surgical debridement of deep intraosseous defects : a randomized controlled trial", J Periodontol, 83, pp.27~35 (2012)
- Checchi L, "A coronally positioned single flap approach in periodontal reconstructive surgery", Dent Cadmos, 76, pp.45~58 (2008)
- Cortellini P, "Improved wound stability with a modified minimally invasive surgical technique in the regenerative treatment of isolated interdental intrabony defects", J Clin Periodontol, 36, pp.157~163 (2009)
- Azuma H, "Single flap periodontal surgery induces early fibrous tissue generation by wound stabilization", J Hard Tissue Biol, 26, pp.119~126 (2017)
- Trombelli L, "Simplified procedures to treat periodontal intraosseous defects in esthetic areas", Periodontol 2000, 77, pp.93~110 (2018)
- Schincaglia GP, "Single versus double flap approach in periodontal regenerative treatment", J Clin Periodontol, 42, pp.557~566 (2015)
- Di Tullio M, "Treatment of supraalveolar-type defects by a simplified papilla preservation technique for access flap surgery with or without enamel matrix proteins", J Periodontol, 84, pp.1100~1110 (2013)
- Trombelli L, "Single-flap approach with buccal access in periodontal reconstructive procedures", J Periodontol, 80, pp.353~360 (2009)
- Farina R, "Early postoperative healing following buccal single flap approach to access intraosseous periodontal defects", Clin Oral Investig, 17, pp.1573~1583 (2013)
- Perumal MP, "Comparison of microsurgical and conventional open flap debridement: a randomized controlled trial", J Indian Soc Periodontol, 19, pp.406~410 (2015)
- Trombelli L, "A simplified composite outcome measure to assess the effect of periodontal regenerative treatment in intraosseous defects", J Periodontol, 91, pp.723~731 (2020)
- Wachtel H, "Microsurgical access flap and enamel matrix derivative for the treatment of periodontal intrabony defects : a controlled clinical study", J Clin Periodontol, 30, pp.496~504 (2003)
- Graziani F, "Does enamel matrix derivative application provide additional clinical benefits in residual periodontal pockets associated with suprabony defects? A systematic review and meta-analysis of randomized clinical trials", J Clin Periodontol, 41, pp.377~386 (2014)
- Gupta M, "Comparison of periodontal open flap debridement versus closed debridement with Er,Cr:YSGG laser", Aust Dent J, 58, pp.41~49 (2013)
- Cortellini P, "Single minimally invasive surgical technique with an enamel matrix derivative to treat multiple adjacent intra-bony defects : clinical outcomes and patient morbidity", J Clin Periodontol, 35, pp.605~613 (2008)
- Harrel SK, "A minimally invasive surgical approach for periodontal bone grafting", Int J Periodontics Restorative Dent, 18, pp.161~169 (1998)
- Kotsilkov K, "Minimally invasive single flap approach with connective tissue wall for periodontal regeneration", J IMAB, 23, pp.1673~1680 (2017)
- Trombelli L, "Effect of a connective tissue graft in combination with a single flap approach in the regenerative treatment of intraosseous defects", J Periodontol, 88, pp.348~356 (2017)
- Pippi R, "Post-surgical clinical monitoring of soft tissue wound healing in periodontal and implant surgery", Int J Med Sci, 14, pp.721~728 (2017)
- Prabhu P, "Wound healing in periodontics", Biosci Biotechnol Res Asia, 11, pp.791~796 (2014)
- Trombelli L, "Management of the soft tissues according to the principles of the single flap approach in the treatment of periodontal intraosseous defects", Dent Clin, 3, pp.5~11 (2008)
- Farina R, "Single-flap approach in combination with enamel matrix derivative in the treatment of periodontal intraosseous defects", Int J Periodontics Restorative Dent, 34, pp.497~506 (2014)
- Jayakumar A, "Horizontal alveolar bone loss : a periodontal orphan", J Indian Soc Periodontol, 14, pp.181~185 (2010)
- Persson RE, "Horizontal alveolar bone loss and vertical bone defects in an adult patient population", J Periodontol, 69, pp.348~356 (1998)
- Papapanou PN, "Periodontal status in relation to age and tooth type. A crosssectional radiographic study", J Clin Periodontol, 15, pp.469~478 (1988)
- Nielsen IM, "Interproximal periodontal intrabony defects. Prevalence, localization and etiological factors", J Clin Periodontol, 7, pp.187~198 (1980)
- Cortellini P, "The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects : clinical outcomes and postoperative morbidity", J Periodontol, 72, pp.1702~1712 (2001)
- Tonetti MS, "Healing, post-operative morbidity and patient perception of outcomes following regenerative therapy of deep intrabony defects", J Clin Periodontol, 31, pp.1092~1098 (2004)
- Trombelli L, "Single flap approach with and without guided tissue regeneration and a hydroxyapatite biomaterial in the management of intraosseous periodontal defects", J Periodontol, 81, pp.1256~1263 (2010)
- Oh SL, "Single-flap approach in periodontal regeneration for intraosseous defects : case series", Clin Adv Periodontics, 10, pp.69~74 (2020)