title: Single-flap approach with buccal access in periodontal reconstructive procedures.
abstract: 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.
authors.affiliation: Research Center for the Study of Periodontal Diseases, University of Ferrara, Ferrara, Italy. leonardo.trombelli@unife.it
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trombelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Farina
authors.forename: Giovanni
authors.initials: G
authors.lastname: Franceschetti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Calura
mesh_terms: 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
chemical_list: D018786:Bone Substitutes; D006882:Hydroxyapatites; D008567:Membranes, Artificial; D003094:Collagen