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A 12 Months Clinical and Radiographic Study to Assess the Efficacy of Open Flap Debridement and Subepithelial Connective Tissue Graft in Management of Supracrestal Defects.

Chhina S - J Int Oral Health (2015)

Bottom Line: However, BL changes did not follow the pattern of clinical improvement on the radiographic assessment of either treatment group.Improvement in different clinical parameters was statistically significant (P < 0.01).Treatment of supracrestal defects with a combination of OFD and SECTG led to significantly better clinical results compared to OFD alone.

View Article: PubMed Central - PubMed

Affiliation: Professor, Department of Periodontics, I.T.S Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India.

ABSTRACT

Background: An improvement in clinical parameters along with regeneration is the desired outcome of periodontal therapy. The aim of this study was to analyze and contrast the efficaciousness of combined open flap debridement (OFD) and subepithelial connective tissue graft (SECTG) to OFD in the management of periodontal supracrestal defects.

Materials and methods: Totally, 20 paired sites exhibiting supracrestal defects were subjected to surgical treatment adopting the split mouth design. The defects were divided randomly for treatment with OFD and SECTG (test) or OFD alone (control). The clinical effectiveness of the two arms of treatment was evaluated at 6 months and 12 months post-operatively by assessing clinical and radiographic parameters. The measurements carried out included probing pocket depth (PPD), relative attachment level (RAL), gingival marginal level, radiographic bone level (BL).

Results: The mean reduction in PPD at 0-12 months was 3.20 ± 0.82 mm and RAL gain of 3.10 ± 1.51 mm was observed, the OFD and SECTG (test) group; corresponding observations for OFD (control) were 2.10 ± 0.63 mm and 1.90 ± 0.57 mm. However, BL changes did not follow the pattern of clinical improvement on the radiographic assessment of either treatment group. Post-operative evaluation was made. Improvement in different clinical parameters was statistically significant (P < 0.01).

Conclusion: Treatment of supracrestal defects with a combination of OFD and SECTG led to significantly better clinical results compared to OFD alone.

No MeSH data available.


Subepithelial connective tissue graft harvested from palate.
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Figure 4: Subepithelial connective tissue graft harvested from palate.

Mentions: Patients were administered 2% lignocaine solution for obtaining anesthesia at the surgical site. Intracrevicular incisions were carried out at buccal and lingual aspects followed by full thickness mucoperiosteal flaps elevation (Figure 3). After the reflection of the flap, a sub-gingival calculus, plaque, pocket epithelium, and diseased granulation tissue were severed and surgical area was completely debrided. The SECTG was harvested from the palate (Figure 4).24 The dimension of the graft was adequate to cover the root surfaces up to the CEJ; the donor site was then secured with horizontal suturing technique. The harvested SECTG was trimmed to remove all visible epithelium, shaped, and placed under coronal part of buccal flap up to CEJ (Figure 5).


A 12 Months Clinical and Radiographic Study to Assess the Efficacy of Open Flap Debridement and Subepithelial Connective Tissue Graft in Management of Supracrestal Defects.

Chhina S - J Int Oral Health (2015)

Subepithelial connective tissue graft harvested from palate.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588774&req=5

Figure 4: Subepithelial connective tissue graft harvested from palate.
Mentions: Patients were administered 2% lignocaine solution for obtaining anesthesia at the surgical site. Intracrevicular incisions were carried out at buccal and lingual aspects followed by full thickness mucoperiosteal flaps elevation (Figure 3). After the reflection of the flap, a sub-gingival calculus, plaque, pocket epithelium, and diseased granulation tissue were severed and surgical area was completely debrided. The SECTG was harvested from the palate (Figure 4).24 The dimension of the graft was adequate to cover the root surfaces up to the CEJ; the donor site was then secured with horizontal suturing technique. The harvested SECTG was trimmed to remove all visible epithelium, shaped, and placed under coronal part of buccal flap up to CEJ (Figure 5).

Bottom Line: However, BL changes did not follow the pattern of clinical improvement on the radiographic assessment of either treatment group.Improvement in different clinical parameters was statistically significant (P < 0.01).Treatment of supracrestal defects with a combination of OFD and SECTG led to significantly better clinical results compared to OFD alone.

View Article: PubMed Central - PubMed

Affiliation: Professor, Department of Periodontics, I.T.S Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India.

ABSTRACT

Background: An improvement in clinical parameters along with regeneration is the desired outcome of periodontal therapy. The aim of this study was to analyze and contrast the efficaciousness of combined open flap debridement (OFD) and subepithelial connective tissue graft (SECTG) to OFD in the management of periodontal supracrestal defects.

Materials and methods: Totally, 20 paired sites exhibiting supracrestal defects were subjected to surgical treatment adopting the split mouth design. The defects were divided randomly for treatment with OFD and SECTG (test) or OFD alone (control). The clinical effectiveness of the two arms of treatment was evaluated at 6 months and 12 months post-operatively by assessing clinical and radiographic parameters. The measurements carried out included probing pocket depth (PPD), relative attachment level (RAL), gingival marginal level, radiographic bone level (BL).

Results: The mean reduction in PPD at 0-12 months was 3.20 ± 0.82 mm and RAL gain of 3.10 ± 1.51 mm was observed, the OFD and SECTG (test) group; corresponding observations for OFD (control) were 2.10 ± 0.63 mm and 1.90 ± 0.57 mm. However, BL changes did not follow the pattern of clinical improvement on the radiographic assessment of either treatment group. Post-operative evaluation was made. Improvement in different clinical parameters was statistically significant (P < 0.01).

Conclusion: Treatment of supracrestal defects with a combination of OFD and SECTG led to significantly better clinical results compared to OFD alone.

No MeSH data available.