title: The papilla amplification flap for the treatment of a localized periodontal defect associated with a palatal groove.
abstract: BACKGROUND
  Teeth with a palatal groove often present with severe localized periodontal attachment loss including pocket formation and alveolar bone loss. The aim of the present case report was to describe the regenerative surgical treatment of periodontal and bone lesions associated with the subgingival extension of a palatal groove affecting a maxillary lateral incisor.
  
  
  METHODS
  The left maxillary lateral incisor of a systemically healthy young subject presented with a palatal probing depth of 10 mm with no gingival recession at the buccal and palatal surfaces; the neighboring interdental papillae were intact. The radiograph showed a radiolucency area distal to the affected tooth. Treatment procedures consisted of: 1) the papilla amplification flap with the use of enamel matrix proteins as the regenerative periodontal material; 2) the elimination/flattening of the radicular portion of the palatal groove; and 3) the sealing of the coronal portion of the groove with composite flow.
  
  
  RESULTS
  The clinical examination at 1 year revealed a clinical attachment gain (8 mm) with a shallow residual probing depth (2 mm) and no increase in gingival recession. The radiographic examination showed the complete disappearance of the radiolucency area suggesting bone fill.
  
  
  CONCLUSIONS
  The present study indicated that localized periodontal defects associated with a palatal groove can be successfully treated by means of the papilla amplification flap with the use of enamel matrix protein as the regenerative material. The long-term stability of such successful results needs to be determined.
authors.affiliation: Alma Mater Studiorum, Department of Periodontology, Bologna University, Bologna, Italy. zucchell@alma.unibo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zucchelli
authors.forename: Monica
authors.initials: M
authors.lastname: Mele
authors.forename: Luigi
authors.initials: L
authors.lastname: Checchi
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery; D001861:Bone Regeneration / Q000187:drug effects; D018786:Bone Substitutes / Q000627:therapeutic use; D003188:Composite Resins; D003746:Dental Enamel Proteins / Q000627:therapeutic use; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D007180:Incisor; D008297:Male; D010159:Palate / Q000601:surgery; D017622:Periodontal Attachment Loss / Q000601:surgery*; D010514:Periodontal Pocket / Q000601:surgery; D013524:Surgical Flaps
chemical_list: D018786:Bone Substitutes; D003188:Composite Resins; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins