Periodontal Healing Following Open Debridement Flap Procedures: I. Clinical Assessment of Soft Tissue and Osseous Repair

Abstract

The healing response of the periodontium was evaluated after periodontal flap and debridement procedures in patients with different levels of postsurgical plaque control. Thirty-one sites in 19 patients were included. Measurements were performed from a fixed reference point presurgically and before reentry surgery. All reentries were performed 24 to 28 weeks after surgery. Surgery consisted of elevating an inverse bevel mucoperiosteal flap, debriding root accretions and osseous defects, penetrating into the marrow, and suturing with interrupted sutures at or near the presurgical level. All patients were recalled at least once every 4 weeks after surgery fof professional maintenance. The number of postsurgical maintenance visits and plaque scores (NPI) before reentry were recorded for each surgical site. Average pocket depth at the 31 sites was 7.4 mm initially and 4.1 mm at the time of reentry. This reduction in pocket depth consisted of gingival recession, which averaged 2.0 mm, and a gain in attachment level, which averaged 1.4 mm. At no site was there a loss in attachment level. Average osseous depth of the 31 defects was 3.7 mm presurgically and 1.7 mm at reentry. In addition, there was an average crestal resorption of 0.8 mm and an average osseous fill of 1.2 mm. A significant positive correlation (P less than 0.001) was found between gain in attachment, osseous fill and number of postsurgical maintenance visits. A significant negative correlation was found between the amount of plaque (NPI) at the study site and both gain in soft tissue attachment and osseous fill. Multiple measurements at various points within several osseous defects revealed that osseous remodeling and fill varied significantly at different locations within the same defect.

Crestal bone resorption after the application of two periodontal surgical techniques. A randomized, controlled clinical trial

“…Kohler and Ramfjord found an average loss of 0.23 mm after MWF (Kohler & Ramfjord 1960), whereas Froum et al showed a bone loss that reached 0.8 mm (Froum et al 1982). Kohler and Ramfjord found an average loss of 0.23 mm after MWF (Kohler & Ramfjord 1960), whereas Froum et al showed a bone loss that reached 0.8 mm (Froum et al 1982).…”

Periodontal Repair in Intrabony Defects Treated With a Calcium Carbonate Implant and Guided Tissue Regeneration

“…19 Only small changes may occur after that up to 12 months.20 Studies evaluating probing depth and clinical attachment changes following GFS have reported improvements similar to those herein reported including probing depth reduction amounting to 3.3 mm and clinical attachment gain amounting to 2.0 mm. [21][22][23][24][25][26][27][28][29] reported probing depth reduction in areas with limited bone regeneration,29 likely an effect of postsurgery gingival recession combined with improved clinical attachment. In the present study, GFS similarly resulted in a significant probing depth reduction concurrent with limited bone level improvements.…”

Bone Apposition in Surgical Bony Defects Following Orthodontic Movement: A Comparative Histomorphometric Study Between Root‐ and Periodontal Ligament‐Damaged and Periodontally Intact Rat Molars

“…[1][2][3][4] This process includes maturation of the gingival connective tissue, formation of long epithelial attachment along the root surface previously exposed to the periodontal pocket, and minimal new connective tissue attachment and bone regeneration. [1][2][3][4] This process includes maturation of the gingival connective tissue, formation of long epithelial attachment along the root surface previously exposed to the periodontal pocket, and minimal new connective tissue attachment and bone regeneration.…”