title: Evaluation of postsurgical clinical outcomes with/without removal of pocket epithelium: A split mouth randomized trial.
abstract: BACKGROUND
  Periodontitis is bacteria-related chronic inflammatory condition characterized by pocket formation, loss of clinical attachment, gingival recession, mobility, and eventual loss of teeth. The purpose of this study was to clinically evaluate the need for elimination of the pocket epithelium during mucoperiosteal flap surgery aimed at reattachment or re-adaptation.
  
  
  METHODS
  A split mouth design was done to compare modified Widman flap (MWF) with removal of the pocket epithelium and crevicular mucoperiosteal flap (CMF) without removing the pocket epithelium. The following measurements were taken after 1 month of completion of nonsurgical phase gingival index (Loe and Silness), plaque index (Silness and Loe), mobility, furcation involvement, level of attachment, pocket depth, gingival recession, gingival contour index, and dentinal hypersensitivity (ice stick test). In addition to these measurements, which were taken immediately prior to the surgery (baseline), 1- and 3-month and 6 months postsurgical measurements were also recorded.
  
  
  RESULTS
  The results of this study showed a greater reduction of mean probing depth in the test group (MWF). The control group (CMF) showed greater mean gingival recession compared to the test group throughout the study period. The test group showed more gain in the clinical attachment levels compared with the control group. The difference between the two groups was statistically significant (P < 0.001).
  
  
  CONCLUSIONS
  The results of this study demonstrate that MWF surgery was more effective in reducing mean probing depth, showed greater gain in clinical attachment, and demonstrated less gingival recession.
authors.affiliation: Department of Periodontics, Dr. Syamala Reddy Dental College, Bengaluru, Karnataka, India.
authors.forename: Shantipriya
authors.initials: S
authors.lastname: Reddy
authors.affiliation: Department of Periodontics, Dr. Syamala Reddy Dental College, Bengaluru, Karnataka, India.
authors.forename: Nirjhar
authors.initials: N
authors.lastname: Bhowmik
authors.affiliation: Department of Periodontics, Dr. Syamala Reddy Dental College, Bengaluru, Karnataka, India.
authors.forename: Malur Gangappa Srinivas
authors.initials: MG
authors.lastname: Prasad
authors.affiliation: Department of Periodontics, Dr. Syamala Reddy Dental College, Bengaluru, Karnataka, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kaul
authors.affiliation: Department of Periodontics, Dr. Syamala Reddy Dental College, Bengaluru, Karnataka, India.
authors.forename: Vinayak
authors.initials: V
authors.lastname: Rao
authors.affiliation: Department of Periodontics, Dr. Syamala Reddy Dental College, Bengaluru, Karnataka, India.
authors.forename: Savita
authors.initials: S
authors.lastname: Singh
keywords: Crevicular mucoperiosteal flap surgery; modified Widman flap surgery; periodontitis; pocket epithelium