The healing potential of the periodontal tissues following different techniques of periodontal surgery in plaque‐free dentitions

TLDR

The study aimed to evaluate periodontal tissue healing after various surgical techniques in patients with optimal plaque control. Fifty patients were randomized into five groups, each receiving a distinct periodontal surgery (apically repositioned flap with or without bone removal, Widman flap with or without bone removal, or gingivectomy with curettage), followed by bi‑weekly professional cleaning over two years. All techniques successfully cured periodontal disease and prevented further tissue loss, but regeneration varied, with the best healing occurring when bone resection was avoided and the alveolar bone was fully covered.

Abstract

Abstract A clinical trial was undertaken to study the healing capacity of the periodontal tissues following different modes of periodontal surgery in patients whose oral hygiene was professionally maintained at an optimal level. Fifty patients, distributed into five groups, participated in the study. Following an initial examination and presurgical treatment, the various patient groups were subjected to one of the following surgical procedures: 1) the apically repositioned flap operation including elimination of bony defects, 2) the apically repositioned flap operation including curettage of the bony defects but without removal of bone, 3) the “Widman flap” technique including elimination of bony defects, 4) the “Widman flap” technique including curettage of the bony defects but without removal of bone, 5) gingivectomy including curettage of the bony defects but without removal of bone. After surgery, all patients received oral hygiene instruction and professional cleaning of the teeth once every 2 weeks during a 2‐year period. The results showed that periodontal disease can be cured and further destruction of the periodontal tissues avoided irrespective of the surgical technique utilized for pocket elimination. Different surgical techniques, however, promoted varying degrees of regeneration of the supporting tissues. The most favourable healing was obtained when resection of bone was avoided and when complete coverage of the alveolar bone was ensured.