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Three Types of Papilla Incision in Periodontal Surgery

ConditionsPeriodontitisPeriodontal DiseasesPeriodontal Pocket
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-80
SponsorUniversidad de Murcia

About this trial

Three types of papilla incision in periodontal reconstruction techniques will be compared.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients diagnosed with periodontal disease.

Active residual pockets associated with intraosseous defects that did not resolve with non-surgical treatment after 1 year of maintenance.

Intraosseous lesions with probing depth greater than 5 mm or extension of the radiographic defect greater than 4 mm.

Plaque index and bleeding index less than 30%.

Disqualifiers

Systemic disease that contraindicates periodontal surgery.

Pregnant women.

Third molars or teeth with incorrect endodontic or restorative treatment.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Midline interproximal soft-tissue incision

    Procedure/Surgery

    Firstly, the marginal tissue will be elevated around the periodontal defect, through the tunneling of the tissues, entering through the gingival sulcus and the periodontal pocket of the teeth involved in the defect periodontal. Once the marginal tissues have been disinserted to full thickness, the soft supra-alveolar component of the defect to be reconstructed will be stretched, in a buccal direction, with a blunt instrument, applying pressure on the lingual aspect. Visualizing the midpoint of the interproximal tissue, the papilla will be dissected at its midpoint, entering through the mesial aspect, with the scalpel blade perpendicular to the central axis of the teeth.

  • Marginal approach by palatal incision

    Procedure/Surgery

    First, an incision will be made in the palatal aspect of the interproximal papilla, at the base of the papilla, parallel to the axis of the tooth until touching the palatine alveolar crest, in order to detach and move the papilla from its base, attached to the vestibular flap. From the palatal incision the interproximal tissue will be elevated towards the buccal until the buccal bone crest is exposed.

  • Minimally invasive surgical technique

    Procedure/Surgery

    The defect will be accessed through an incision at the base of the papilla on the vestibular aspect. Depending on the anatomy of the interproximal space, two types of incisions will be made: simplified papilla preservation flap (SPPF) when the width of the interproximal space is equal to or less than 2 mm, or modified papilla preservation technique (MPPT) when the width is greater than 2 millimeters. The interproximal incision will extend intrasulcular on the lingual and buccal aspect of the teeth adjacent to the defect, and mesio-distally it will extend as necessary to allow access to the defect and its debridement. The papilla will move from its base towards the palatine.

Treatment groups

30 Participants
are divided into 3 treatment groups
Group A: Midline interproximal soft-tissue incisionExperimental treatment 1 intervention
Group B: Marginal approach by palatal incisionActive comparator 1 intervention
Group C: Minimally invasive surgical techniqueActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Bleeding on probing

Bleeding on probing could be positive or negative

Time frame
12 months
2

Clinical attachment level (CAL)

Clinical attachment level will be assessed with a periodontal probe, measured in mm from the cementoenamel junction (CEJ) to the bottom of the pocket

Time frame
12 months
3

Probing pocket depth (PD)

Probing pocket depth will be assessed with a periodontal probe, measured in mm from the gingival margin to the bottom of the pocket

Time frame
12 months
4

Recession (REC)

Recession, will be assessed with a periodontal probe, measured in mmm on the buccal aspect, from the CEJ to the gingival margin zenith.

Time frame
12 months

Secondary outcomes

1

Supra-alveolar attachment gain (SUPRA-AG)

Subtracting the 12 month CAL from the intrasurgically Bone Component-CEJ will provide the SUPRA-AG result.

Time frame
12 months

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Universidad de Murcia

Lead sponsor

Source ClinicalTrials.gov
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