Single-Flap Approach in Combination with Enamel Matrix Derivative in the Treatment of Periodontal Intraosseous Defects

Effect of a Connective Tissue Graft in Combination With a Single Flap Approach in the Regenerative Treatment of Intraosseous Defects

“…Presurgery and surgical procedures were performed by expert periodontal surgeons (LT, LM, RF, GR) involved in previous clinical trials on SFA 7‐12,15 …”

“…On digital photographs taken as perpendicular as possible to the long axis of the tooth presenting the intraosseous defect at presurgery, an examiner (AS) assessed the following parameters using dedicated software: 10–12 ** 1) thickness of the buccal gingival tissue: the transparency of a periodontal probe through the gingival tissues when probing the buccal aspect of the tooth was evaluated according to a previously described method; 23 if the probe was visible through the gingival tissues, the tissue was defined as “thin”; otherwise, it was defined as “thick”; 2) buccal REC (bREC), measured from the CEJ to the gingival margin (bREC was recorded as 0 when the gingival margin was located coronal to the CEJ); 3) keratinized tissue width (KT), measured from the gingival margin to the mucogingival junction.…”

“…Therefore, the present study population is a convenience sample. A post‐hoc power calculation was performed, assuming an SD in the primary outcome of 1.1 mm, as derived from a previous study 11 on the SFA in combination with DBBM and EMD, and an intergroup difference of 1 mm. A per protocol study population of 30 patients (15 treated with an SFA, 15 treated with an SFA+CTG) had a power of 78.2% in detecting a significant intergroup difference at a P level of 0.05.…”

“…In this context, the single flap approach (SFA) is proposed, a simplified surgical procedure for treatment of intraosseous defects 5–15 . The basic underlying principle of the SFA consists of the elevation of a limited mucoperiosteal flap to allow access to the defect from either the buccal or oral aspect only, depending on the main buccal/oral extension of the lesion (as assessed by preoperative bone sounding), allowing the interproximal supracrestal gingival tissues to remain intact.…”

“…The basic underlying principle of the SFA consists of the elevation of a limited mucoperiosteal flap to allow access to the defect from either the buccal or oral aspect only, depending on the main buccal/oral extension of the lesion (as assessed by preoperative bone sounding), allowing the interproximal supracrestal gingival tissues to remain intact. The SFA was shown to be associated with low mean postoperative REC increase, with six of seven prospective clinical trials reporting mean REC variations within 1 mm at 6 months after surgery 7‐12,15 . Also, lower post‐surgery REC increase was observed after an SFA compared with papilla preservation techniques in either conservative or regenerative therapy of intraosseous lesions 9 , 15 …”