Clinical evaluation of impact of periodontal phenotype on the outcome of open flap debridement in patients with chronic periodontitis: A comparative interventional study

J Periodontol. 2021 Aug;92(8):1171-1180. doi: 10.1002/JPER.19-0668. Epub 2020 Nov 21.

Abstract

Background: Several studies have implicated the role of periodontal phenotype (PP) in the outcome of various periodontal interventions. However investigations have not been performed to estimate such impact on the outcome of open flap debridement (OFD) for the management of chronic periodontitis.

Methods: A total of 73 individuals with chronic periodontitis underwent scaling and root planing (SRP). Eight weeks following SRP, modified Widman flap (MWF) surgery was performed in 40 patients (20 of either PP) presenting with probing depth (PD) ≥4 mm and gingival index (GI) ≥1 at ≥4 sites distributed over ≥2 anterior teeth with radiographic evidence of horizontal bone loss. PD, clinical attachment level (CAL), gingival recession, plaque index, GI, and bleeding on probing (BOP) were recorded at baseline, 3 and 6 months. PP was assessed using transparency of periodontal probe through the gingival margin at midfacial level.

Results: A total of 34 patients were re-evaluated after intervention. All periodontal parameters improved in both groups after periodontal surgery. PD & PP were found to have positive correlation with CAL gain in ≥7 mm probing sites. Attachment gain of >2 mm was observed in more percentage of sites in thick PP than in thin PP.

Conclusion: PP can be an important factor influencing CAL gain in OFD.

Keywords: chronic periodontitis; clinical attachment level; flap; periodontal phenotype; surgical procedure.

MeSH terms

  • Chronic Periodontitis* / surgery
  • Debridement
  • Dental Scaling
  • Follow-Up Studies
  • Humans
  • Periodontal Attachment Loss / surgery
  • Periodontal Pocket / surgery
  • Phenotype
  • Root Planing