Single‐Flap Approach for Surgical Debridement of Deep Intraosseous Defects: A Randomized Controlled Trial

Abstract

The surgical debridement of intraosseous periodontal defects resulted in comparable, substantial CAL gains and PD reductions as well as limited postoperative REC increases when defects were accessed with the SFA or DFA.

Effect of a Connective Tissue Graft in Combination With a Single Flap Approach in the Regenerative Treatment of Intraosseous Defects

“…Previous randomized clinical trials have clearly demonstrated that an SFA may optimize clinical outcomes compared with a conventional double‐flap approach when used with 15 or without 9 regenerative devices, while limiting the level of post‐surgery pain and discomfort 15 . Adjunctive use of a CTG unavoidably results in a more technically demanding procedure and increases the intra‐ and postoperative morbidity due to the need for an additional surgical site for graft harvesting.…”

“…Presurgery and surgical procedures were performed by expert periodontal surgeons (LT, LM, RF, GR) involved in previous clinical trials on SFA 7‐12,15 …”

“…In this context, the single flap approach (SFA) is proposed, a simplified surgical procedure for treatment of intraosseous defects 5–15 . The basic underlying principle of the SFA consists of the elevation of a limited mucoperiosteal flap to allow access to the defect from either the buccal or oral aspect only, depending on the main buccal/oral extension of the lesion (as assessed by preoperative bone sounding), allowing the interproximal supracrestal gingival tissues to remain intact.…”

“…The basic underlying principle of the SFA consists of the elevation of a limited mucoperiosteal flap to allow access to the defect from either the buccal or oral aspect only, depending on the main buccal/oral extension of the lesion (as assessed by preoperative bone sounding), allowing the interproximal supracrestal gingival tissues to remain intact. The SFA was shown to be associated with low mean postoperative REC increase, with six of seven prospective clinical trials reporting mean REC variations within 1 mm at 6 months after surgery 7‐12,15 . Also, lower post‐surgery REC increase was observed after an SFA compared with papilla preservation techniques in either conservative or regenerative therapy of intraosseous lesions 9 , 15 …”

“…The SFA was shown to be associated with low mean postoperative REC increase, with six of seven prospective clinical trials reporting mean REC variations within 1 mm at 6 months after surgery 7‐12,15 . Also, lower post‐surgery REC increase was observed after an SFA compared with papilla preservation techniques in either conservative or regenerative therapy of intraosseous lesions 9 , 15 …”