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A new flap design for placement of implants into osseous defects has been described. The flap design can be used in anterior and posterior areas of human subjects. Photographs of representative cases are presented. Wound healing always occurred by primary intention and without evidence of immediate graft exfoliation. Interdental soft tissue craters did not develop, making it easier for patients to maintain optimal oral hygiene. This type of flap design can also be used without grafts in order to improve postoperative soft tissue contour.

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Interproximal bony defects were treated with either porous hydroxyapatite (PHA) or decalcified freeze-dried bone allograft (DFDB) implants at two different clinical centers. Twelve paired defects in 12 patients were treated at each center. Six months post-surgically the defects were measured to assess changes from the presurgical status. No statistically significant differences were found between the groups in changes in gingival fluid, bleeding index, plaque index, or tooth mobility. The porous hydroxyapatite implant produced greater reduction in pocket depth (P = 0.03) and more gain in clinical attachment level (P = 0.001) and defect fill (P = 0.001) when compared with DFDB grafted sites. This study indicates that more clinical resolution of interproximal periodontal defects in humans can be obtained with the use of PHA than with the use of DFDB.

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