Evaluation of Non-Incised Papillae Surgical Approach (NIPSA) Versus Conventional Flap in Periodontal Reconstructive Surgery of Intrabony Defects (Clinical and Radiographic Study)

Ten patients were included in this group, phase I therapy (scaling, root planing and oral hygiene measures) was performed. A single horizontal or oblique incision was made in the mucosa located on the cortical bone tissue, apical to the intrabony defect. The mesiodistal extension of the incision was sufficient to allow access to the defect. Tissue coronal to the incision was raised to full thickness from the incision line to expose the bone peaks delimiting the intrabony defect. The granulation tissue was removed from the bone walls of the defect. Dental plaque and calculus deposits were removed from the root surface with ultrasonic scaler tips and micro-minicurettes. A solution of 24% Ethylenediaminetetraacetic acid (EDTA) was applied to the root surface for 2 min, irrigation with saline solution then allograft bone material was packed into the periodontal defect. The incision was sutured with horizontal internal mattress sutures then simple interrupted sutures.

"Ten patients were included in this group, phase I therapy (scaling, root planing and oral hygiene measures) was performed. Intrasulcular incision was made splitting the buccal papilla from the palatal papilla. All defects were approached by elevating a flap only on the buccal side and leaving the oral portion of the interdental supracrestal soft tissues undetached. The full-thickness elevation of the marginal portion of the flap was performed with a microsurgical periosteal elevator.~After removal of granulation tissue from the bone walls of the defect, root and defect debridement was performed with manual and mechanical (ultrasonic) instruments with tips for subgingival instrumentation.~A solution of 24% Ethylenediaminetetraacetic acid (EDTA) was applied to the root surface for 2 min, irrigation with saline solution then allograft bone material was packed into the periodontal defect. The incision was sutured with simple interrupted sutures."