Single Flap Approach With and Without Guided Tissue Regeneration and a Hydroxyapatite Biomaterial in the Management of Intraosseous Periodontal Defects

Background: The single flap approach (SFA) is a minimally invasive procedure designed for periodontal reconstructive procedures of intraosseous periodontal defects characterized by a dominant unilateral, buccal or oral, extension. This study evaluates the adjunctive effect of guided tissue regeneration (GTR) combined with a hydroxyapatite (HA) biomaterial in the management of intraosseous periodontal defects accessed with SFA compared to SFA alone. Methods: Twenty-four intraosseous defects (in 24 patients) were randomly allocated to treatment with SFA or SFA + HA/GTR. Clinical outcomes were assessed 6 months post-surgery. Results: Five sites in the SFA + HA/GTR group showed incomplete closure at week 2, which resolved spontaneously. There were no statistically significant or clinically meaningful differences in mean (+/- SD) clinical attachment gain (4.7 +/- 2.5 versus 4.4 +/- 1.5 mm), probing depth reduction (5.3 +/- 2.4 versus 5.3 +/- 1.5 mm), and gingival recession increase (0.4 +/- 1.4 versus 0.8 +/- 0.8 mm) between the SFA + HA/GTR and SFA groups. Conclusions: SFA with and without HA/GTR seems to be a valuable minimally invasive approach in the treatment of deep intraosseous periodontal defects. Under the present experimental conditions, the additional HA/GTR protocol offers no significant adjunctive effect. J Periodontol 2010;81:1256-1263.