The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures

A novel surgical procedure specifically designed to access interdental spac es in the regenerative treatment of deep intrabony defects is presented. Th is procedure (simplified papilla preservation flap, SPPF) was designed to p rovide surgical access to interproximal bony defects while preserving inter dental soft tissues, even in narrow interdental spaces and posterior teeth. A modified mattress suture allows coronal positioning of the buccal flap a nd primary closure of the interdental space without tension. The modified m attress suture minimizes the collapse of the membrane into the defect. An e xperimental population of 18 patients in good general health who presented with one intrabony defect each was selected for this clinical study The app lication of the SPPF in combination with bioresorbable membranes resulted i n clinical attachment level (CAL) gains of 4.9 +/- 1.8 mm at 1 year. The di fference between baseline CAL and 1 year CAL was highly clinically and stat istically significant. The residual pockets at 1 year measured 3.6 +/- 1.2 mm. A slight increase in gingival recession was noted. Primary closure of t he nap in the interdental space over the membrane was obtained in 100% of t he cases after completion of surgery and maintained in 67% of the cases dur ing the healing period,The application of SPPF in combination with bioresor bable barrier membranes allowed primary closure of the interdental space in most of the treated sites and resulted in consistent CAL gains at 1 year.