Coronally Advanced Entire-Papilla Preservation Flap with Recombinant Human Platelet-Derived Growth Factor and...

BACKGROUND Use of the coronally advanced entire-papilla preservation flap has been proposed to address the challenges of achieving primary closure in regenerative procedures. Platelet-derived growth factor, when combined with bone grafts, has been associated with enhanced periodontal tissue regeneration. Through promoting angiogenesis and cellular proliferation, this procedure has potential in contributing to favorable clinical outcomes. CASE REPORT A 36-year-old male patient presented with a deep intrabony defect measuring 9 mm on the mesial surface of tooth #11. To preserve the vascular supply of the papilla associated with the defect, a coronally advanced entire-papilla preservation flap was performed. The defect was degranulated and root planed, followed by application of freeze-dried bone allograft mixed with recombinant human platelet-derived growth factor (rhPDGF-BB). A connective tissue graft was harvested and placed over the defect to enhance soft tissue thickness. The flap was coronally advanced and sutured without tension, achieving primary wound closure. At the 6-month follow-up, the soft tissue demonstrated favorable healing with no gingival recession, a reduction in probing depth from 9 to 3 mm, and radiographic evidence of bone fill. CONCLUSIONS This case highlights the potential clinical benefits of using a coronally advanced entire-papilla preservation flap combined with rhPDGF-BB and bone graft to promote periodontal regeneration. The technique preserved papilla integrity and maintained vascular supply, resulting in favorable clinical and esthetic outcomes in this single case.