Entire Papilla Preservation Technique in the Treatment of Periodontal IntraBony Defects: a 1-year Follow-up Study (EPP)

Entire Papilla Preservation Technique in the Treatment of Periodontal Intra-Bony Defects: a One-Year Clinical Follow-Up Study on Its Efficacy and Outcomes

The aim of this study was to investigate the radiographic and clinical outcomes associated with the whole papilla preservation technique in the treatment of isolated intraosseous defects in patients with stage III periodontitis. The records of 17 systemically healthy patients (12 women and 5 men) diagnosed with stage III periodontitis who underwent the whole papilla preservation technique three months after nonsurgical periodontal treatment were evaluated. The following clinical parameters were recorded at baseline and after treatment: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), probing depths (PD), clinical attachment level (CAL) and gingival recession (GR). The early healing index (EHI) score was assessed 1 week after surgery in both groups. CAL gain was determined as the primary outcome. Baseline data as well as follow-up assessments at 1 month, 3 months, 6 months and 1 year were analyzed to determine the efficacy and long-term outcomes of the treatment.

Study Overview

• Status: Active, not recruiting
• Conditions: Periodontal Diseases; Periodontal Bone Loss
• Intervention / Treatment: Procedure: ENTİRE PAPİLLA PRESERVATİON

• Study Type: Observational
• Enrollment (Actual): 17

Contacts and Locations

Study Locations

• Turkey
  • Konya, Turkey, 42090
    • Konya Necmettin Erbakan Üniversitesi
  • Meram
    • Konya, Meram, Turkey, 42090
      • Konya Necmettin Erbakan Üniversitesi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The aim of this study was to evaluate the data of 17 systemically healthy patients (12 males and 5 females) aged between 22 and 60 years (mean age 41.5 ± 5.96 years) who underwent a surgical procedure three months after completion of non-surgical periodontal therapy (NSPT).

Description

Inclusion Criteria:

• • Systemically healthy individuals.

  • Patients who underwent reconstructive periodontal surgery following the completion of non-surgical treatment.
  • Presence of at least one isolated two- or three-wall intrabony defect with probing depth (PD) ≥7 mm, clinical attachment level (CAL) ≥7 mm and at least 4 mm intrabony component involving predominantly the interproximal area of the affected tooth
  • Full-mouth plaque score (FMPS) and full-mouth bleeding score ≤20%

Exclusion Criteria:

• Individuals who smoke
• Individuals with uncontrolled systemic disease
• Individuals using drugs that affect periodontal tissues
• Individuals during pregnancy and breastfeeding
• Presence of single-walled intraosseous defects
• Flood restoration
• Inadequate endodontic treatment

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Entire Papila Preservation Tecnique; This innovative approach allows for vertical access to the defect site from the buccal and lingual sides without making incisions in the papillary region. Its goal is to minimize the risk of wound healing failure and the exposure of regenerative biomaterials by fully preserving the interdental papilla over the bony defect

Procedure: ENTİRE PAPİLLA PRESERVATİON; The "EPP" technique is a tunnel-like approach of the defect-associated inter-dental papilla. Surgical loupes (3.3× magnification) with LED light illumination were used to increase visibility of the surgical site. Following a buccal intra-crevicular incision, a bevelled vertical releasing incision was performed in the buccal gingiva of the neighbouring inter-dental space and extended just beyond the mucogingival line to provide appropriate mechanical access to the intrabony defect.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PROBİNG DEPTH	Probing Depth (PD) refers to the distance from the gingival margin to the base of the periodontal pocket. It is expressed in mm and a high measurement is a clinically unfavorable value	1 YEARS
Clinical Attachment Level	Clinical Attachment Level (CAL) is defined as the distance from the cementoenamel junction (CEJ) to the base of the periodontal pocket. It is expressed in mm and a high measurement is a clinically unfavorable value.	1 YEARS

Collaborators and Investigators

• Sponsor: Necmettin Erbakan University

Study record dates

Study Major Dates

• Study Start (Actual): July 25, 2024
• Primary Completion (Estimated): December 15, 2024
• Study Completion (Estimated): December 15, 2024

Study Registration Dates

• First Submitted: December 2, 2024
• First Submitted That Met QC Criteria: December 19, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 19, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Keywords: clinical attachment level; microsurgery
• Additional Relevant MeSH Terms: Bone Resorption; Bone Diseases; Musculoskeletal Diseases; Periodontal Atrophy; Mouth Diseases; Stomatognathic Diseases; Alveolar Bone Loss; Periodontal Diseases
• Other Study ID Numbers: 2024/470

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No