Conventional Flap vs Entire Papilla Preservation Technique in Vertical Bone Defects with DFDBA and PRF: A...

This study aimed to compare the conventional flap and entire papilla preservation technique to treat vertical defects with demineralized freeze-dried bone allograft (DFDBA) and platelet-rich fibrin (PRF).

Fourteen patients having bilateral vertical defects were selected with a split-mouth design. Fourteen paired defects were treated randomly using DFDBA + PRF with the entire papilla preservation technique (Group A) or conventional flap (Group B). Clinical parameters recorded plaque index (PI), sulcus bleeding index (SBI), pocket depth (PD), and clinical attachment level (CAL) at baseline, six, and nine months after surgery. Radiographic parameters recorded defect fill, alveolar crest height change, and defect fill at six and nine months.

Both groups had statistically significant (P < 0.05) reductions in mean PI, SBI, PD, defect depth (radiographic), and CAL gain. The mean defect fill percentage at six and nine months (75.07 ± 12.55 vs. 87.20 ± 7.05) was significantly higher in Group A compared to Group B (68.83 ± 15.26 at 6 vs 81.28 ± 11.54). The mean interdental papilla recession was greater in Group B at both six and nine months (5.64 ± 1.00 mm vs 6.64 ± 1.00 mm) as compared to Group A (1.86 ± 0.66 mm vs 2.71 ± 0.61 mm). Significant reductions were observed in mean PD and gain in alveolar crest levels in Group A as compared to Group B at nine months.

The study had certain limitations, but the conclusion is that both groups showed enhanced periodontal regeneration with DFDBA and PRF, but due to preservation of papilla in Group A, there was decreased interdental recession as compared to Group B.