Entire-papilla preservation is effective technique for treating intrabony defects, JCP Digest

The novel approach of treating deep intrabony defects with the entire-papilla preservation (EPP) technique without the adjunctive use of biomaterials is effective in increasing clinical attachment levels, according to research summarised in the latest issue of JCP Digest.

In periodontal tissue regeneration, common complications involve exposure of the biomaterials and the loss of the gingival papilla. These complications are associated with surgical techniques that require a papillary incision.

Various techniques have been proposed to avoid such complications, and EPP is the latest in a series of approaches that includes the use of enamel matrix derivatives (EMD), alternative flap designs (papilla-preservation techniques), and minimally invasive techniques.

Researchers Serhat Aslan, Nurcan Buduneli, and Pierpaolo Cortellini compared the clinical efficacy of EPP alone versus EPP combined with both EMD and bovine-derived bone substitute (BDS) in a randomised controlled clinical trial.

Summarised as JCP Digest issue number 76, this study found that, as well as its effectiveness in terms of CAL gain, the technique was “ideal” to apply in isolated two-wall interproximal intrabony defects with a missing buccal bony wall.

The research also found that, because of the lack of elevation of the interdental papilla, first-intention healing was achieved. Furthermore, patients were satisfied by the surgical procedure and experienced no complications.

The authors said that further randomised, controlled clinical trials were needed to assess the benefits of the different papilla-preservation techniques in comparison with each other.

The research was summarised for JCP Digest by students of the EFP-accredited postgraduate programme in periodontology and implant dentistry at the University of Strasbourg in France.

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