Regenerative Periodontal Treatment with the Single Flap Approach in Smokers and Nonsmokers

Trombelli, Leonardo; Farina, Roberto; Minenna, Luigi; Toselli, Luca; Simonelli, Anna

doi:10.11607/prd.3615

Cited by 10 publications

(20 citation statements)

References 15 publications

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“…We also analyzed the influence of smoking on clinical outcomes and found no significant differences between smokers and non‐smokers in terms of PDr and CAG, as did in another study of intraosseous defects but unlike others . However, the WC results were significantly worse in smokers ( P < 0.05), as reported by Trombelli et al.…”

Section: Discussionsupporting

confidence: 60%

“…However, the WC results were significantly worse in smokers ( P < 0.05), as reported by Trombelli et al. (2018) and unlike the results found by Farina et al. (2013), who analyzed WC after a marginal approach to the defect .…”

Section: Discussionmentioning

confidence: 48%

“…38 We also analyzed the influence of smoking on clinical outcomes and found no significant differences between smokers and non-smokers in terms of PDr and CAG, as did in another study of intraosseous defects 39 but unlike others. 40,41 However, the WC results were significantly worse in smokers (P < 0.05), as reported by Trombelli et al (2018) 39 and unlike the results found by Farina et al (2013), who analyzed WC after a marginal approach to the defect. 34 They found, as we did, that the type of WC did not have a significant impact (P > 0.05) on the clinical outcome at 1 year.…”

Section: Discussionmentioning

confidence: 68%

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Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Rodríguez

Ruiz

Caffesse

2018

Journal of Periodontology

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Background The objective of this study was to compare a minimally‐invasive surgical technique (MIST) and a non‐incised papilla surgical approach (NIPSA) in periodontal reconstructive surgery of deep intraosseous defects. Methods Data on 30 patients with a deep intraosseous defect treated with MIST (n = 15) or NIPSA (n = 15) were analyzed retrospectively. All patients met the same inclusion criteria and were treated following the same protocol, except for the surgical management of soft tissue (MIST versus NIPSA). Clinical parameters at baseline and at 1‐year post‐surgery, early healing at 1 week, and postoperative pain were assessed. Results NIPSA and MIST resulted in significant clinical attachment gain (CAG) (P < 0.001) and probing depth reduction (PDr) (P < 0.001) at 1‐year post‐surgery. However, NIPSA resulted in significantly lower recession of the tip of the interdental papilla compared with MIST (P < 0.001). Smoking negatively influenced early healing in both techniques (P < 0.05). Conclusions NIPSA and MIST both resulted in significant improvements in clinical parameters. NIPSA showed significant soft tissue preservation. NIPSA may represent a promising papillae preservation technique in the treatment of intraosseous periodontal defects.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 68%

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Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Rodríguez

Ruiz

Caffesse

2018

Journal of Periodontology

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“…In the present systematic review, we decided to exclude smokers to avoid possible bias considering that smoking affects the wound healing process [85]. Indeed, in a recent clinical study [86] in which the impact of smoking status on the clinical outcomes after regenerative surgical procedures were evaluated, the authors concluded that in smoker patients wound healing quality was significantly hampered when compared to non-smokers. A dose-dependent effect of smoking was observed with respect to the values of PD reduction and CAL gain at 6 months with a tendency to lower values in patients consuming 11–20 cigarettes/day than in smokers from 1 to 10 cigarettes/day.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the studies focus however on the long-term clinical outcomes after 12 months [76]. In addition, in none of the studies included in the present revision, early wound healing was evaluated with any of the indices/systems already proposed in the literature [23, 24, 86].…”

Section: Discussionmentioning

confidence: 99%

Early wound healing outcomes after regenerative periodontal surgery with enamel matrix derivatives or guided tissue regeneration: a systematic review

et al. 2019

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Background Proper wound healing after regenerative surgical procedures is an essential issue for clinical success. Guided tissue regeneration (GTR) and application of enamel matrix derivatives (EMD) are common means to regenerate periodontal tissues. Both methods bear considerable advantages due to their special characteristics, but also go along with certain disadvantages. Today, there is no consensus in the literature whether GTR or EMD show better results regarding early wound healing, which is considered a crucial stage in periodontal regeneration. Therefore, the aim of the present systematic review was to compare the early wound healing after regenerative periodontal surgery with either EMD or GTR treatment. Methods An electronic literature search in PubMed was performed to identify randomized clinical trials (RCTs) or clinical trials (CTs) comparing regenerative surgery employing EMD and/or GTR in patients with chronic periodontitis. Among the finally included studies, a qualitative and quantitative data extraction regarding early wound healing parameters was performed. Primary outcome parameters were early wound healing index (EWH), flap dehiscence, membrane exposure, suppuration and abscess formation during the first 6 weeks. As secondary parameters, swelling and allergic reactions were assessed. Results Seven studies reporting 220 intrabony periodontal defects in 199 patients were analysed. Flap dehiscence was observed in two studies in 12% of the GTR treated sites and in 10.3% of those treated with EMD. Membrane exposure was evaluated in five studies and was registered in the 28.8% of the defects, while no dehiscence was reported on the EMD group. Swelling was reported only in one study in 8/16 GTR sites and 7/16 EMD sites. Due to considerable heterogeneity of parameters no meta-analysis was possible. Conclusions Due to considerable heterogeneity of the published studies a clear beneficial effect of the EMD on the early wound healing outcomes after surgical treatment of periodontal intrabony defects cannot be confirmed. Standardized RCT studies are needed in order to allow for proper comparison of early wound healing after both types of surgical approaches.

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Prognostic value of a composite outcome measure for periodontal stability following periodontal regenerative treatment: A retrospective analysis at 4 years

Simonelli

Farina

Minenna

et al. 2023

Journal of Periodontology

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BackgroundRecently, a composite outcome measure (COM) was proposed to describe the short‐term results of periodontal regenerative treatment. The present retrospective study aimed at evaluating the prognostic value of COM on clinical attachment level (CAL) change over a 4‐year period of supportive periodontal care (SPC).MethodsSeventy‐four intraosseous defects in 59 patients were evaluated at 6 months and 4 years following regenerative treatment. Based on 6‐month CAL change and probing depth (PD), defects were classified as: COM1 (CAL gain ≥3 mm, PD ≤4 mm); COM2 (CAL gain <3 mm, PD ≤4 mm); COM3 (CAL gain ≥3 mm, PD >4 mm); or COM4 (CAL gain <3 mm, PD >4 mm). COM groups were compared for “stability” (i.e., CAL gain, no change in CAL or CAL loss <1 mm) at 4 years. Also, groups were compared for mean change in PD and CAL, need for surgical retreatment, and tooth survival.ResultsAt 4 years, the proportion of stable defects in COM1, COM2, COM3, and COM4 group was 69.2%, 75%, 50%, and 28.6%, respectively, with a substantially higher probability for a defect to show stability for COM1, COM2, and COM3 compared with COM4 (odds ratio 4.6, 9.1, and 2.4, respectively). Although higher prevalence of surgical reinterventions and lower tooth survival were observed in COM4, no significant differences were detected among COM groups.ConclusionsCOM may be of value in predicting CAL change at sites undergoing SPC following periodontal regenerative surgery. Studies on larger cohorts, however, are needed to substantiate the present findings.

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Regenerative Periodontal Treatment with the Single Flap Approach in Smokers and Nonsmokers

Cited by 10 publications

References 15 publications

Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Periodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non‐incised papillae surgical approach (NIPSA): A retrospective cohort study

Early wound healing outcomes after regenerative periodontal surgery with enamel matrix derivatives or guided tissue regeneration: a systematic review

Prognostic value of a composite outcome measure for periodontal stability following periodontal regenerative treatment: A retrospective analysis at 4 years

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