Single-Flap Approach in Periodontal Regeneration for Intraosseous Defects: Case Series

A single-flap approach (SFA) is the elevation of a periodontal flap to access the defect only from one side. Several studies have reported that the SFA is at least as clinically effective as the elevation of a flap at both buccal and palatal/lingual aspects. However, studies regarding the SFA have reported only 6 to 10 months follow-up clinical outcomes. The purpose of this case series was to investigate the outcomes of the SFA for periodontal regeneration with a collagen membrane and bone grafts in regard to linear bone defect fill and clinical parameters such as gingival recession (GR), pocket depth (PD), and clinical attachment level (CAL) for the 15-month follow-up.

Based on the deepest pocket depth site, the flap retraction side for each case, either buccal or palatal/lingual, was determined. After retraction of a one-side full thickness flap, complete removal of granulation tissue and thorough scaling and root planing were performed. Demineralized ground cortical bone grafts were gently packed into the defect areas and an absorbable collagen membrane was placed over the grafts in 13 cases from 11 patients.

This case series demonstrated that the SFA for periodontal regeneration with a collagen membrane and bone grafts resulted in decreased PD with minimum GR, gain in CAL, and bone fill at defect sites for the 15-month follow-up.