Intrabony Periodontal Defect Clinical Trial
Official title:
Clinical and Radiographic Evaluation of the Non-Incised Papilla Surgical Approach With and Without Allograft Plus Platelet Rich Fibrin in Treatment of Intraosseous Defects in Stage III Periodontitis Patients: A Randomized-Controlled Clinical Trial
Several minimal invasive techniques have been proposed since the last decade aiming to enhance and provide adequate environment for periodontal regeneration. Harrel and Rees proposed minimally invasive surgery (MIS) in 1995 and minimal invasive surgical technique (MIST) that was introduced in 2007 and then further enforced with modified minimally invasive surgical technique (M-MIST) in 2009 . A new minimal invasive technique called Non-Incised Papilla Surgical Approach (NIPSA) was introduced in 2017. It is aims to maintain the marginal tissues integrity by placing horizontal or oblique incision apical to the defect approaching the defect through apical access.
Intraosseous vertical defects are one of the consequences that could result from
periodontitis, which are classified according to their architecture by the number of residual
walls, defect width as well as topographic extension in relation to the tooth.
Conventional surgery done for regenerative purpose regarding vertical defects has been known
to be affected by clot stability, it was reported in the literature that reduced clinical
outcomes occurred when early wound failure and exposure of the treated area occurred. This
led to the innovation of different minimally invasive flap techniques that aimed at reducing
the surgical trauma, allowing blood clot stability, protecting the regenerating site,
reducing patient discomfort postoperatively as well as minimizing surgical chair time Among
these techniques are papilla preservation flaps and minimally invasive surgical approaches
with papilla elevation or without papilla elevation . However, these techniques had in their
design incisions related to the interdental papilla which would jeopardize and complicate the
vascular integrity of the interdental tissues Non incised Papilla surgical approach is a new
surgical technique introduced by Moreno Rodriguez in 2017 to maintain the marginal tissues
and the papilla intact by placing a horizontal or oblique incision apical to the defect and
approaching it through an apical access leaving the marginal tissues to act as a "dome "
protecting the blood clot
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