Papillary Retention Flap Design for Pocket Reduction/Regeneration: Case Series With Long-Term Follow-Up

Many papillary preservation flap techniques exist for both resective and regenerative purposes. This article describes a papillary retention design based on palatal access showing a successful long-term outcome. The papilla preservation approach detailed here, which is a modification of Friedman's beveled flap for the palate, circumvents any manipulation of interproximal or buccal tissue, leaving papillary tissue untouched. Indications for this approach are very specific and its application is somewhat limited. However, the aim of the papillary retention flap as discussed is to eradicate pocket depths exceeding 5 mm and possibly regenerate hard and connective tissue in these exclusive locations. This strategy may permit access to the labial portion of the interproximal root in particular cases.