Single-flap versus double-flap approach for periodontal pocket reduction in supraosseous defects: a comparative study

Abstract

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

Single-flap approach versus without concentrate growth factor in the treatment of periodontal supra-osseous defects: A randomized controlled clinical trial

“…SFA reported improved periodontal clinical outcomes when compared to the double flap approach in the treatment of infra-bony defects ( Trombelli et al, 2018 , Trombelli et al, 2020 , Trombelli et al, 2021 ). Till now, limited data are available regarding the use of SF design in the treatment of periodontal osseous defects although these limited data have reported favorable promising results ( Mathala et al, 2021 , Windisch et al, 2022 ).…”

“…The single flap approach (SFA) was developed to overcome these drawbacks and treat intraosseous defects. Its main advantages come from repositioning and suturing to the undetached papilla, which allows the best wound healing, limited surgical trauma, better tissue esthetics, and minimal bone loss compared to the conventional approach ( Mathala et al, 2021 ,).…”

“…Although SFA has proven effective in treating various periodontal defects, its efficacy in periodontal regenerative therapy, however, requires further verification. ( Mathala et al, 2021 , Simonelli et al, 2021 , Windisch et al, 2022 ). Therefore, we aimed to assess if combining the beneficial effects of CGF and SFA could achieve better post-treatment periodontal and patient-centered outcomes in managing periodontal supra-bony defects.…”

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

“…18 According to COM, treatment outcomes are classified into four different scenarios, including "successful treatment" when a clinically relevant result (i.e., a CAL gain ≥3 mm) is associated with the absence of a residual pocket (i.e., PD ≤4 mm) (COM1), "treatment failure" when limited CAL gain (<3 mm) is associated with a residual pocket (i.e., PD >4 mm) (COM4), and intermediate conditions characterized by limited CAL gain in association with pocket closure (COM2) or relevant CAL gain in association with a residual pocket (COM3). Since its description in 2020, COM has been used by other authors to describe the effect of periodontal regenerative treatments at both short-term [33][34][35][36] and long-term observation intervals. 14 In the present study, the association between COM and the 4-year clinical outcomes of periodontal regenerative treatment (as assessed in terms of periodontal stability, need for surgical retreatment due to disease recurrence, and tooth survival) was evaluated.…”

The Role of Oral Fusobacterium nucleatum in Female Breast Cancer: A Systematic Review and Meta-Analysis

“…Nonetheless, there are innumerable disadvantages such as membrane exposure, fap dehiscence, oedema, the absence of primary closure of interdental spaces, and bleeding [60]. With increasing importance being placed on SFA MIST and concomitant use of dental loupes, numerous articles concur that clinical outcomes of delicate tissues such as the gingiva are greatly improved as a result due to (i) reduced bleeding during operative procedures, (ii) minimal fap refections without periosteal incisions, and (iii) precise incisions promoting healing by primary intention via easy stabilisation of the undetached papilla [30,[61][62][63].…”