Single-flap approach versus without concentrate growth factor in the treatment of periodontal supra-osseous defects: A randomized controlled clinical trial

Abstract

Objectives: We aimed to compare treatment outcomes of periodontal supra-bony defects using single flap (SFA) plus concentrate growth factor versus SFA alone.

Methods: 32 supra-bony periodontal defects were randomly assigned to test and control groups. Outcome variables were clinical attachment level (primary outcome). Probing pocket depths, gingival recessions, bone gain, post-surgical pain using visual analogue scale and wound healing index were recorded as secondary outcomes. Clinical and radiographic assessments were recorded at baseline and 6 months after treatment, whereas pain score and wound healing index were recorded within 10 days after surgery.

Results: Test group showed a significant improvement in all tested parameters compared to control group (P-value ≤ 0.05). Better patient centered outcomes (wound healing and pain scores) were highly achieved in the test group compared to controls.

Conclusion: The tested combined approach offers better periodontal and patient centered treatment outcomes in management of periodontal supra-bony defects.

Keywords: Concentrate growth factor; Minimally invasive flap; Randomized controlled trial; Supra bony defects; Surgical periodontal therapy.

Fig. 1

CONSORT 2010 Flow Diagram.

Fig. 2

(1) CBCT sagittal cut showing measurement of supra bony defect before treatment. (a) a horizontal, butt-joint incision was performed 1–2 mm coronal to the bone crest. (b) a buccal mucoperiosteal envelope flap (SFA) was elevated, and the defect was debrided manually. (c) CGF preparation. (d), defects were filled with CGF between the roots inter-proximal below the undetached papilla and extending to cover the root surface buccally. (e) a horizontal internal mattress suture. (f) 21-day healing. (2) CBCT sagittal cut showing measurement of supra bony defect 6 months after treatment.