Entire papilla preservation technique for treatment of periodontal intrabony defects: a series of cases.

OBJECTIVE: Periodontitis is characterized by bone resorption. Vertical bone loss results in an intraosseous defect. Multiple surgical approaches for treating intrabony defects have shown different grades of effectiveness. Recently, the entire papilla preservation technique has been proposed, improving clinical parameters, such as pocket depth and clinical attachment level. This series of cases aimed to describe the use of the entire papilla preservation surgical technique without using biomaterials to regenerate periodontal intrabony defects. The influence on the clinical periodontal parameters and radiographic parameters was measured through CBCT, the latter not described until now, and analyzed the possible postoperative complications. METHOD AND MATERIALS: A total of six intrabony periodontal defects associated with at least one periodontal pocket with probing depths equal to or greater than 6 mm were treated with the entire papilla preservation technique. The clinical and radiographic parameters were evaluated at the beginning and 6 months after surgery. RESULTS: The mean probing pocket depth reduction was 4.00 ± 0.63 mm, the mean clinical attachment level gain was 3.67 ± 1.03 mm, and the mean radiographic intrabony filling was 2.41 ± 2.03 mm. Early healing was uneventful; the mean visual analog scale at 7 days was 0. CONCLUSIONS: This minimally invasive technique results in an improvement in clinical and radiographic parameters, the latter showing a filling of the bone defect observed during the 6-month evaluation after surgical treatment. These results confirm the importance of clot and flap stability in regenerating intraosseous defects.

Dimensional changes of the post extraction alveolar ridge, preserved with Leukocyte- and Platelet Rich Fibrin: A clinical pilot study.

OBJECTIVES: This clinical trial explored the clinical and radiographic dimensional changes of the alveolar ridge in the first 4 months after tooth extraction in combination with the application of Leukocyte- and Platelet Rich Fibrin (L-PRF). METHODS: Eighteen single rooted maxillary and mandibular sockets were filled with L-PRF without soft tissue closure. Clinical measurements (bone sounding) were performed using a customized acrylic stent and radiographic measurements were accomplished using Cone Beam Computed Tomography (CBCT), immediately after tooth extraction and after 4 months. RESULTS: The clinical observations indicated a mean horizontal resorption of 1.18±2.4mm (p=0.8) at the crest, 1.25±2.0mm (p=0.57) and 0.83±2.0mm (p=0.78) at 2mm and 4mm apical to the crest, respectively. The buccal plate demonstrated a mean vertical loss of 0.44±3.5mm (p=0.9), the centre of the socket had a significant filling of 5.72±3.6mm (p=0.0001) and the oral cortical plate had a mean vertical gain of 0.09mm±1.57mm (p=0.9). The radiographic analysis demonstrated a mean vertical bone loss of 0.27±2.5mm (p=0.9) on the buccal and of 0.03±1.6mm (p=0.9) at the oral crest. The width of the alveolar ridge had a mean loss of 1.33mm±1.43mm. CONCLUSIONS: Within the limitations of this pilot study, it can be concluded that L-PRF might show clinical benefits for ridge preservation.