A Comparative Evaluation Of Non-Incised Papillae And Entire Papilla Preservation Surgical Approaches In Treatment Of Intrabony Defects. A Clinical And Radiographic Study

Aim & ObjectivesThe aim of the present study was to clinically and radiographically compare and evaluate the NIPSA (Non-Incised Papillae Surgical Approach) and EPP (Entire Papilla Preservation) techniques in the treatment of intra bony defects. Patients and methodsFrom this initial patient pool of 156 patients, 44 individuals satisfying the inclusion criteria were selected. One site in each subject was assigned into each of the following experimental groups which were treated with the relevant procedure; NIPSA and EPP groups. Clinical parameters included the recording of pocket probing depths (PPD), clinical attachment levels (CAL) and papilla loss. The evaluation of bone fill was performed at the end of 3 & 6-months by using Image J(R) software. ResultsNIPSA and EPP resulted in highly significant CAL gains (4.00{+/-}1.00 vs 5.25 {+/-} 1.47mm; p[≤]0.001) and PPD reductions (3.352{+/-}0.70 vs 3.625{+/-}1.024mm; p[≤]0.001) at 6-months post-surgery. From the start to the end of study period, NIPSA resulted in almost no papilla loss (1.71{+/-}0.47 to 1.73{+/-}0.77mm) while EPP technique showed minimal and insignificant (1.57{+/-}0.52 to 1.48{+/-}0.71mm; p[≥]0.05) papilla loss. The EPP group revealed a highly significant (0.459{+/-}0.16 vs 0.269{+/-}0.16cm2; p[≤]0.001) bone fill over NIPSA group at 6-months. ConclusionFrom this trial conducted over a period of 6-months, NIPSA and EPP both resulted in significant improvements in clinical outcomes. NIPSA and EPP showed favourable outcomes in terms papilla loss and bone fill respectively. Both the techniques achieve the aims outlined earlier and broaden the choice available to a periodontist in the management of intrabony defects.