Single-flap approach with buccal access in periodontal reconstructive procedures

Area of Science:

• Periodontology
• Regenerative Dentistry
• Oral Surgery

Background:

• Periodontal intraosseous defects require reconstructive procedures to optimize outcomes.
• Minimally invasive techniques like the single-flap approach (SFA) aim to reduce surgical trauma.
• SFA is indicated for defects prevalent on one side (buccal or oral), accessing the defect from a single aspect.

Purpose of the Study:

• To evaluate the clinical effectiveness of the single-flap approach (SFA) with buccal access.
• To assess the use of a collagen membrane and hydroxyapatite (HA)-based biomaterial in SFA for periodontal reconstruction.
• To report preliminary data on the regenerative treatment of deep periodontal intraosseous defects.

Main Methods:

• A case series involving 10 patients with 10 intraosseous defects.
• Defects were accessed using a buccal SFA.
• Treatment involved a collagen membrane and an HA-based graft biomaterial, with follow-up ranging from 6 to 14 months.

Main Results:

• Clinical attachment level (CAL) improved significantly, decreasing from 11.2 mm to 6.4 mm.
• Probing depth reduced from 9.0 mm to 3.8 mm.
• Gingival recession showed a minimal increase from 2.2 mm to 2.6 mm.

Conclusions:

• SFA combined with grafting and guided tissue regeneration can achieve substantial CAL gain in challenging intraosseous defects.
• The limited postsurgical recession suggests SFA is a viable option for esthetically sensitive areas.
• SFA offers a potentially suitable minimally invasive surgical option for periodontal defect reconstruction.