Periodontal Diseases, Periodontal Pocket, Periodontitis
Conditions
Brief summary
Three types of papilla incision in periodontal reconstruction techniques will be compared.
Interventions
PROCEDUREMidline interproximal soft-tissue incision
Firstly, the marginal tissue will be elevated around the periodontal defect, through the tunneling of the tissues, entering through the gingival sulcus and the periodontal pocket of the teeth involved in the defect periodontal. Once the marginal tissues have been disinserted to full thickness, the soft supra-alveolar component of the defect to be reconstructed will be stretched, in a buccal direction, with a blunt instrument, applying pressure on the lingual aspect. Visualizing the midpoint of the interproximal tissue, the papilla will be dissected at its midpoint, entering through the mesial aspect, with the scalpel blade perpendicular to the central axis of the teeth.
First, an incision will be made in the palatal aspect of the interproximal papilla, at the base of the papilla, parallel to the axis of the tooth until touching the palatine alveolar crest, in order to detach and move the papilla from its base, attached to the vestibular flap. From the palatal incision the interproximal tissue will be elevated towards the buccal until the buccal bone crest is exposed.
The defect will be accessed through an incision at the base of the papilla on the vestibular aspect. Depending on the anatomy of the interproximal space, two types of incisions will be made: simplified papilla preservation flap (SPPF) when the width of the interproximal space is equal to or less than 2 mm, or modified papilla preservation technique (MPPT) when the width is greater than 2 millimeters. The interproximal incision will extend intrasulcular on the lingual and buccal aspect of the teeth adjacent to the defect, and mesio-distally it will extend as necessary to allow access to the defect and its debridement. The papilla will move from its base towards the palatine.
Sponsors
Universidad de Murcia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with periodontal disease. * Active residual pockets associated with intraosseous defects that did not resolve with non-surgical treatment after 1 year of maintenance. * Intraosseous lesions with probing depth greater than 5 mm or extension of the radiographic defect greater than 4 mm. * Plaque index and bleeding index less than 30%.
Exclusion criteria
* Systemic disease that contraindicates periodontal surgery. * Pregnant women. * Third molars or teeth with incorrect endodontic or restorative treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Probing pocket depth (PD) | 12 months | Probing pocket depth will be assessed with a periodontal probe, measured in mm from the gingival margin to the bottom of the pocket |
| Bleeding on probing | 12 months | Bleeding on probing could be positive or negative |
| Clinical attachment level (CAL) | 12 months | Clinical attachment level will be assessed with a periodontal probe, measured in mm from the cementoenamel junction (CEJ) to the bottom of the pocket |
| Keratinized tissue width (KT) | 12 months | Keratinized tissue width will be assessed with a periodontal probe, measured in mm on the buccal aspect, from the gingival margin to the mucogingival line. |
| Recession (REC) | 12 months | Recession, will be assessed with a periodontal probe, measured in mmm on the buccal aspect, from the CEJ to the gingival margin zenith. |
| Location of the tip of the papillae (TP) | 12 months | Location of the tip of the papillae. Taking as reference the level of the mid-axis of the tooth, will be measured the distance from the CEJ at the zenith of the tooth to the tip of the papilla. A positive value will be recorded when the tip of the papillae is located coronally to the CEJ and a negative value otherwise. This outcome will be assessed with a periodontal probe and measured in mm. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Supra-alveolar attachment gain (SUPRA-AG) | 12 months | Subtracting the 12 month CAL from the intrasurgically Bone Component-CEJ will provide the SUPRA-AG result. |
Countries
Spain
Contacts
Primary ContactANTONIO J ORTIZ-RUIZ, MD
Outcome results
None listed