Outcomes of Periodontal Regenerative Surgery Performed by Periodontology Trainees

This prospectively-collected longitudinal service evaluation assessed the outcomes of periodontal regenerative surgery performed by periodontology trainees in the MClinDent program at Guy's Hospital, London. The primary aim was to evaluate 12-month clinical outcomes, with secondary aims to explore predictors of success and (reported separately) assess the feasibility of predicting defect morphology radiographically.

Data from 173 intrabony defects in 133 patients (October 2020-May 2023) were analysed. Primary outcomes were pocket closure (PC; PPD ≤4 mm, no BoP) and composite outcome measure (COM; PC + CAL gain ≥3 mm). Descriptive and multilevel multivariate analyses were performed, with univariate analyses interpreted as exploratory.

At 12 months, mean CAL gain was 2.78 mm, PPD reduction 3.27 mm, with PC in 58% and COM in 45% of sites. Radiographically, mean intrabony reduction was 3.3 mm, with ≥3 mm reduction in 52% of sites. Multivariate models identified full-mouth plaque score (p=0.024) and suprabony defect depth (p=0.036) as predictors of COM, and intrabony defect depth as predictor of PC (p=0.002).

Regenerative surgery performed by trainees achieved meaningful clinical and radiographic improvements, with outcomes comparable to published ranges but slightly less predictable than in specialist-led trials. Plaque control and defect morphology were key determinants of success, highlighting the importance of case selection and supportive care. The exploratory nature of predictor analyses, constrained by sample size and subgroup representation, underscores the need for validation in larger, controlled studies.