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

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.

Multidisciplinary approach involving strategic implant placement before orthodontic (SIMBO) treatment for generalized stage IV grade C periodontitis: A case report with 10‐year follow‐up

“…The favorable results obtained in our patient might also be attributed to the minimally invasive periodontal surgery using a microscope and microsurgical instruments with the intent of preserving papillae and maintaining both blood supply and wound stability 14,15 . Further, the thick, flat periodontal phenotype in our patient might have facilitated primary wound closure and prevented exposure of the implanted materials, aiding in the achievement of long‐term favorable results 44,46 …”

“…14,15 Further, the thick, flat periodontal phenotype in our patient might have facilitated primary wound closure and prevented exposure of the implanted materials, aiding in the achievement of long-term favorable results. 44,46 Prior to implant placement, the m-HBP was utilized to provide rest for the neuromusculature and periodontal attachment apparatus and an adequate occlusal plane. The device was also useful for examining CR, including vertical/horizontal discrepancies for fabricating the pre-orthodontic setup model.…”

Gingival phenotype determination: Cutoff values, relationship between gingival and alveolar crest bone thickness at different landmarks

“…Multiple studies have well established that GP evaluation plays an pivotal role in the treatment planning and the clinical outcomes of different dental treatment procedures, including open flap debridement，periodontal plastic surgery, immediate implant placement and orthodontic treatment. 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 Gumber et al. investigated the impact of GP on the treatment outcome of open flap debridement for chronic periodontitis and found higher percentage of clinical attachment gain (>2 mm) in sites with thick GP than that with thin GP.…”

“…investigated the impact of GP on the treatment outcome of open flap debridement for chronic periodontitis and found higher percentage of clinical attachment gain (>2 mm) in sites with thick GP than that with thin GP. 31 Treatment outcomes of implant placement are also heavily influenced by GP. It has been revealed that thin GP is associated with more mucosal recession and bone marginal loss than thick GP.…”

“… 37 It is noteworthy that different GP evaluation methods were used in abovementioned studies, including periodontal probe transparency (TRAN method) and transgingival probing method. 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 …”