Purpose The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes. Trial Registration Clinical Trials Registry-India Identifier: CTRI/2018/05/013562

PurposeTo evaluate the effectiveness of bupivacaine and lidocaine local anesthesia on the intra-surgical and post-surgical pain control in patients undergoing periodontal flap surgery. Materials and MethodsA randomized, single-blind, split-mouth design was employed in patients who are scheduled for periodontal flap surgery for at least two similar sextants with similar anesthetic techniques. Fifty patients (age range 16-65 years, 32 males and 28 females) enrolled in the present study. On one-site, the flap surgery was performed using 2% lidocaine with 1:200000 epinephrine and on the other with 0.5% bupivacaine with 1:200000 epinephrine. Base line clinical parameters, probing pocket depth, clinical attachment level were recorded. Pain during intra operative period, at the time of loss of numbness and for three consecutive days was measured using visual analog scale (VAS). ResultsSignificant differences were observed between the two groups in the intra operative pain scores (p=0.0045) and pain scores at the time of loss of numbness (p=0.0005) but not at the 1st, 2nd and 3rd day after the surgery. ConclusionBupivacaine was markedy more effective than the lidocaine. Thus the usage of bupivacaine can be substantiated for periodontal surgeries for the control of pain in the intra operative and immediate post-operative period to increase patients' comfort.

Introduction: Achieving regeneration of the lost periodontal structures after surgical approach plays a major role. This healing can be interrupted due to the presence of invasive bacteria which is present in the periodontal tissues. Aim: To compare laser-assisted and conventional flap surgery using microsurgical instruments and under surgical operating microscope with hydroxyapatite graft in the treatment of intrabony defects. Materials and Methods: This prospective randomised split-mouth clinical study was conducted in Department of Periodontology at Vishnu Dental College, Bhimavaram, Andhra Pradesh, India, from June 2020 to December 2021. A total of 24 bilateral intrabony defects were selected for the study. Control sites (n=12) received the graft after conventional open flap debridement. In the test group (n=12), graft placement was done followed by laser irradiation with diode laser (980 nm, power: 3.0 W; frequency 2.5 KHz) for 30 seconds. The entire flap surgery procedure was performed under Surgical Operating Microscope (SOM). Clinical parameters such as plaque index, gingival index, probing depth, relative attachment level, were assessed at 3 months and 6 months. Healing index was assessed after 7 days of surgery. Radiographic parameters were assessed at baseline and 6 months using Cone Beam Computed Tomography (CBCT). Descriptive statistics, Independent samples t-test, repeated measures analysis of variance and Paired t-tests were used in data analysis. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: Intragroup comparison showed statistical significance in all clinical and radiographical parameters (p-value<0.001). Intergroup comparison between the test and control group did not show any statistical significance in terms of plaque index, gingival index, relative Clinical attachment level, probing depth (p-value≥0.05). Intragroup comparison of the depth of defect was statistically significant in both test (p-value=0.011) and control groups (p-values=0.002). Intergroup comparison did not show any statistical significance in linear bone fill (p-value=0.1). Intergroup comparison did not show any statistical significance in defect angle (p-value=0.773). No statistical significance was obtained in percentage fill (p-value=0.074). Intergroup comparison did not show any statistical significance in the clinical and radiographical parameters. Conclusion: The additional laser irradiation at the test site did not exhibit any significant benefits in the bone regeneration. All the outcomes were similar in test and control group.

Preservation of periodontal health after periodontal therapy is paramount for the complete elimination of periodontal diseases. In most of the Dental Schools, recall appointments are considerably low, and in particular, to the Department of Periodontics, the compliance to recall visits by the patients diagnosed with periodontal disease is still inadequate. Faculty from the Department of Periodontics framed new criteria to follow in the comprehensive clinics by the postgraduate students. The criteria include communication, intraoral examination skills, and professionalism toward dental patients. Faculty in each comprehensive dental clinic observed the clinical encounters of postgraduate students with patients and provided the feedback. The study conducted from May 2018 to April 2019, and the patients attended were 1164 of 1544. Unattended patients were 380 of 1544. Effective evaluation of the feedback provided by faculty and communication with both the postgraduate students and unattended patients resulted in further improvement in recall, that is, 151 of 380 patients. Reframed criteria, direct observation of the postgraduate students by faculty during patients interaction, assessment of feedback forms, and immediately modifying the student’s way of communication allowed maximum recall visits to the Department of Periodontics.