A Minimally Invasive Osseous Resective Surgical Protocol for Pocket Elimination at Maxillary and Mandibular Posterior Sextants: MI-PES.

IF 1.3 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE International Journal of Periodontics & Restorative Dentistry Pub Date : 2024-01-01 DOI:10.11607/prd.6673
Leonardo Trombelli, Mattia Severi
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Abstract

The purpose of the present study was to describe a novel protocol for a minimally invasive pocket elimination surgery (MI-PES) in the posterior maxilla and mandible, which consists of the combined use of (1) an access flap based on an internally beveled gingivectomy with minimal to no papilla mobilization at the buccal aspect, and (2) a resective procedure with an apically positioned flap on the lingual aspect. The interproximal bone defects were accessed with a single (lingual) flap, and the bone architecture was modified by the adoption of piezoelectric inserts for controlled bone recontouring associated with fiber retention. Mean probing depth (PD) was 5.5 ± 0.8 mm before surgery and 2.7 ± 0.6 mm at the 6-month reevaluation. All treated pockets showed a postsurgical PD < 4 mm. Gingival recession (REC) was 0.3 ± 0.5 mm at baseline and increased to 1.6 ± 0.8 mm at 6 months. When buccal and lingual pockets were analyzed separately, a trend toward a similar PD reduction, less REC increase, and greater clinical attachment level gain was recorded for buccal pockets. These preliminary observations seem to support the use of MI-PES as a valuable option for pocket elimination, at least when residual pockets are associated with a shallow interproximal osseous crater in the posterior maxilla or mandible.

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用于消除上颌和下颌后六分仪凹陷的微创骨性切除手术方案:MI-PES。
本研究的目的是描述一种新的上颌和下颌后牙微创窝洞消融手术(MI-PES)方案,该方案包括:(1)联合使用基于内斜面龈切除术的入路皮瓣,在颊侧尽量少动甚至不动乳头;(2)在舌侧使用顶端定位皮瓣进行切除手术。通过单个(舌侧)翻瓣进入近端间骨缺损,并通过采用压电插件对骨结构进行修改,以控制与纤维保持相关的骨整复。术前的平均探诊深度(PD)为 5.5 ± 0.8 毫米,6 个月复查时为 2.7 ± 0.6 毫米。所有治疗后的牙周袋探诊深度均小于 4 毫米。牙龈退缩(REC)基线为 0.3 ± 0.5 毫米,6 个月时增加到 1.6 ± 0.8 毫米。对颊面袋和舌面袋分别进行分析后发现,颊面袋的 PD 下降趋势相似,REC 增加较少,临床附着水平增加较多。这些初步观察结果似乎支持使用 MI-PES 作为消除牙周袋的重要选择,至少在残余牙周袋与上颌或下颌后部的浅基底间骨坑相关联时是如此。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
113
审稿时长
6-12 weeks
期刊介绍: The International Journal of Periodontics & Restorative Dentistry will publish manuscripts concerned with all aspects of clinical periodontology, restorative dentistry, and implantology. This includes pertinent research as well as clinical methodology (their interdependence and relationship should be addressed where applicable); proceedings of relevant symposia or conferences; and quality review papers. Original manuscripts are considered for publication on the condition that they have not been published or submitted for publication elsewhere.
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