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Non‐surgical retreatment versus papillary preservation flap surgery for residual pockets: A randomized controlled trial with clinical and patient‐reported outcomes

Title: Non‐surgical retreatment versus papillary preservation flap surgery for residual pockets: A randomized controlled trial with clinical and patient‐reported outcomes
Authors: Barbato, Luigi; Noce, Desirée; Di Martino, Maria; Castelluzzo, Walter; Spoleti, Folco; Rupe, Cosimo; Nieri, Michele; Cairo, Francesco
Source: Journal of Clinical Periodontology ; volume 51, issue 10, page 1277-1288 ; ISSN 0303-6979 1600-051X
Publisher Information: Wiley
Publication Year: 2024
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Aim To compare the efficacy of non‐surgical re‐instrumentation (NSR) and papillary preservation flap (PPF) surgery at single‐rooted teeth with residual pockets. Materials and Methods Patients with at least a residual pocket depth (PD ≥ 5 mm) after Steps I and II were enrolled and randomly assigned to receive NSR or PPF surgery. The primary outcome was PD reduction, and secondary outcomes were clinical attachment level (CAL) change and patient‐reported outcome measures (PROMs). Outcome variables were measured at baseline, 3 and 6 months. The examiner was blinded. Statistical analysis, one site for each patient, included descriptive statistics and analysis of covariance. Results Forty‐six participants were enrolled, and one patient dropped out in the PPF group. After 6 months, both treatments resulted in significant PD reduction (1.3 ± 1.2 mm, p = .009 NSR; 2.0 ± 0.7 mm, p < .001 PPF) and CAL gain (1.0 ± 2.4 mm, p = .031 NSR; 1.4 ± 0.8 mm, p < .001 PPF). PD reduction between groups was not statistically significant (diff: 0.6 mm; 95% confidence interval [CI] [−0.3 to 1.5]; p = .167). Pocket closure was 61% NSR versus 86% PPF ( p = .091). Smoking was associated with less PD reduction of almost 1 mm in both treatments. Treatment time was longer for PPF surgery, but PROMs and post‐operative pain were similar between groups. Conclusions Both NSR and PPF reduced PD without significant difference between treatments at 6 months. PPF surgery may offer faster PD reduction, but smoking habits reduce treatment efficacy.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/jcpe.14047
Availability: https://doi.org/10.1111/jcpe.14047; https://onlinelibrary.wiley.com/doi/pdf/10.1111/jcpe.14047
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.5713C768
Database: BASE