Supra-alveolar attachment gain in the treatment of combined intra-suprabony periodontal defects by non-incised papillae surgical approach

J Clin Periodontol. 2019 Sep;46(9):927-936. doi: 10.1111/jcpe.13158. Epub 2019 Jul 22.

Abstract

Aim: To assess the effectiveness of non-incised papillae surgical approach (NIPSA) in periodontal reconstructive surgery of combined intra-suprabony defects.

Materials and methods: Patients with deep periodontal defects treated with NIPSA (n = 20) were analysed. Defects were treated with enamel matrix derivative plus xenograft. Clinical outcomes were assessed before surgery and at 12 months. Wound closure was assessed one week post-surgery. Supra-alveolar attachment gain (SUPRA-AG) was recorded at 12 months post-surgery.

Results: Non-incised papillae surgical approach showed significant improvements in clinical attachment gain (5.9 ± 2.38 mm; p < 0.001), recession reduction (0.25 ± 0.44; p < 0.05) and tip of the papillae coronal displacement (0.4 ± 0.5; p < 0.05). It also showed complete wound closure of the apical mucosal incision in the 85% of the cases, with no interproximal tissue necrosis. SUPRA-AG (1.9 ± 1.74) showed a positive tendency, associated with complete intrabony defect resolution.

Conclusions: Non-incised papillae surgical approach promoted primary intention healing, wound stability and space provision for optimal periodontal reconstruction, preserving supra-alveolar soft tissue integrity.

Keywords: periodontitis; reconstructive surgery; regeneration; surgical flaps.

MeSH terms

  • Alveolar Bone Loss*
  • Bone Transplantation
  • Dental Enamel Proteins*
  • Follow-Up Studies
  • Guided Tissue Regeneration, Periodontal
  • Humans
  • Periodontal Attachment Loss
  • Treatment Outcome

Substances

  • Dental Enamel Proteins