Single versus double flap approach in periodontal regenerative treatment.
OBJECTIVE
to compare the outcomes of a regenerative strategy based on recombinant human platelet-derived growth factor-BB (rhPDGF-BB, 0.3 mg/ml) and β-tricalcium phosphate (β-TCP) in the treatment of intraosseous defects accessed with the Single Flap Approach (SFA) versus Double Flap Approach based on papilla preservation techniques (DFA).


METHODS
Fifteen and 13 defects, randomly assigned to SFA or DFA, respectively, were grafted with rhPDGF-BB + β-TCP. Probing parameters were assessed before and 6 months after surgery. Pain (VAS(pain)) was self-reported using a visual analogue scale.


RESULTS
Twelve SFA sites and DFA 6 sites showed complete flap closure at 2 weeks post-surgery. No significant differences in 6-month changes in probing parameters and radiographic defect fill were found between groups. Significantly lower VAS(pain) was observed in SFA group compared to DFA group at day +1, +2 and +6. A significantly greater number of analgesics were consumed in the DFA group compared to the SFA group at day +1.


CONCLUSIONS
When combined with rhPDGF-BB and β-TCP, the SFA may result in similar clinical outcomes, better quality of early wound healing, and lower pain and consumption of analgesics during the first postoperative days compared to the DFA.
Division of Periodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT, USA.|Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.
Gian Pietro
GP
Schincaglia
Division of Periodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT, USA.
Eric
E
Hebert
Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.
Roberto
http://orcid.org/0000-0002-4621-7809
R
Farina
Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.
Anna
A
Simonelli
Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.
Leonardo
L
Trombelli
D000328:Adult; D010520:Aggressive Periodontitis / Q000601:surgery; D016301:Alveolar Bone Loss / Q000601:surgery*; D000700:Analgesics / Q000627:therapeutic use; D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use*; D000077214:Becaplermin; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D055113:Chronic Periodontitis / Q000601:surgery; D003646:Debridement / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D020574:Proto-Oncogene Proteins c-sis / Q000627:therapeutic use*; D016300:Radiography, Bitewing / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery*; D016896:Treatment Outcome
D000700:Analgesics; D043925:Angiogenesis Inducing Agents; D001672:Biocompatible Materials; D002130:Calcium Phosphates; D020574:Proto-Oncogene Proteins c-sis; C485817:beta-tricalcium phosphate; D000077214:Becaplermin
beta tricalcium phosphate; periodontitis; platelet-derived growth factor; surgical flaps; wound healing