Comparison of gingival blood flow during healing of simplified papilla preservation and modified Widman flap surgery: a clinical trial using laser Doppler flowmetry
: Blackwell Synergy
Aim: This prospective randomized-controlled clinical trial compared the gingival
blood flow responses following simplified papilla preservation (test) versus modified
Widman flap (control).
Materials and Methods: Twenty contra-lateral upper sites with pocket depthX5mm
after initial treatment in 10 chronic periodontitis patients were randomly assigned to
either test or control treatment, using a split-mouth design. Laser Doppler flowmetry
recordings were performed pre-operatively, following anaesthesia, immediately postoperatively
and on days 1, 2, 3, 4, 7, 15, 30 and 60, at nine selected sites per flap.
Results: Significant ischaemia was observed at all sites following anaesthesia and
immediately post-operatively. At the mucosal flap basis, a peak hyperaemic response
was observed on day 1, which tended to resolve by day 4 at the test sites, but persisted
until day 7 at the control sites. The buccal and palatal papillae blood perfusion
presented the maximum increase on day 7 in both groups and returned to baseline by
day 15. Both surgical modalities yielded significant pocket depth reduction, recession
increase and clinical attachment gain.
Conclusions: Periodontal access flaps represent an ischaemiaÃ¢â‚¬â€œreperfusion flap model.
The simplified papilla preservation flap may be associated with faster recovery of the
gingival blood flow post-operatively compared with the modified Widman flap.
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