Single‐Flap Approach for Surgical Debridement of Deep Intraosseous Defects: A Randomized Controlled Trial

Abstract

The single-flap approach (SFA) consists of the elevation of a limited mucoperiosteal flap to allow surgical access to periodontal defects from either the buccal or oral aspect only, leaving the interproximal supracrestal gingival tissues intact. The aim of the present randomized controlled trial is to assess the effectiveness of a buccal SFA used for the surgical debridement of deep intraosseous defects compared to the double-flap approach (DFA). Fourteen patients were treated according to SFA principles and 14 patients received the DFA. In all patients, root surfaces and defects were thoroughly debrided, and conditions for the primary intention healing and blood clot stability were ensured by a proper flap design and suture technique. The clinical attachment level (CAL), probing depth (PD), and gingival recession (REC) were assessed immediately before surgery and at 6 months post-surgery. The results of the study indicate that: 1) the SFA and DFA resulted in significant CAL gains and PD reductions at 6 months post-surgery; and 2) the SFA was similarly effective compared to the DFA in terms of CAL gain and PD reduction. The surgical debridement of intraosseous periodontal defects resulted in comparable, substantial CAL gains and PD reductions as well as limited postoperative REC increases when defects were accessed with the SFA or DFA.