Single-flap approach with buccal access in periodontal reconstructive procedures.
BACKGROUND
New surgical techniques have been developed to optimize primary closure as well as to minimize the surgical trauma in the reconstructive procedures of periodontal intraosseous defects. Recently, we proposed a minimally invasive procedure, the single-flap approach (SFA), specifically indicated when the defect extension is prevalent on the buccal or oral side. The basic principle of the SFA is the elevation of a flap to access the defect only on one side (buccal or oral), leaving the opposite side intact. The present case series reports preliminary data on the clinical effectiveness of SFA with buccal access in conjunction with a collagen membrane and a hydroxyapatite (HA)-based biomaterial in the reconstructive treatment of deep periodontal intraosseous defects.


METHODS
Ten intraosseous defects in 10 patients were accessed with a buccal SFA and treated with a collagen membrane and an HA-based graft biomaterial. The follow-up period following the regenerative procedure ranged from 6 to 14 months (mean: 10.0 +/- 3.0 months).


RESULTS
Clinical attachment level (CAL) decreased from 11.2 +/- 2.6 mm presurgery to 6.4 +/- 1.9 mm post-surgery. Probing depth was 9.0 +/- 2.8 mm before surgery and 3.8 +/- 1.5 mm post-surgery. Gingival recession increased from 2.2 +/- 1.9 mm presurgery to 2.6 +/- 1.3 mm post-surgery.


CONCLUSIONS
Challenging intraosseous defects, surgically accessed with a buccal SFA and treated with a combined graft/guided tissue regeneration technique, may heal with a substantial CAL gain. Limited postsurgical recession indicates that SFA may represent a suitable option to surgically treat defects in areas with high esthetic demands.
Trombelli
Leonardo
L
Research Center for the Study of Periodontal Diseases, University of Ferrara, Ferrara, Italy. leonardo.trombelli@unife.it
Farina
Roberto
R
Franceschetti
Giovanni
G
Calura
Giorgio
G
D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D001861:Bone Regeneration; D018786:Bone Substitutes; D003094:Collagen; D012534:Dental Scaling; D005260:Female; D005889:Gingival Recession / Q000517:prevention & control; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D006882:Hydroxyapatites; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D013524:Surgical Flaps
D018786:Bone Substitutes; D006882:Hydroxyapatites; D008567:Membranes, Artificial; D003094:Collagen