Background and objective: Periodontal regenerative therapy is an effective treatment to improve bone loss, inhibit further progression of periodontal disease, and contribute to the oral health of patients. In recent years, various flap designs have been devised with better results. In this report, we present three cases of deep vertical bone defects treated with periodontal regenerative therapy using the non-incised papillae surgical approach (NIPSA) to preserve the interdental papillae.
Cases: Patients were 43, 56, and 76 years old (all female), no underlying disease, one smoker and two nonsmokers, all with Stage IV Grade C severe periodontitis, and vertical bone defects greater than 3 mm.
Results: OHI, scaling, and SRP under local anesthesia were performed. No antimicrobial agents were used. Periodontal regenerative therapy was performed for vertical bone defects using a dental microscope and NIPSA. After debridement, EMD was applied and a bovine bone (Bio-oss) was placed in the bone defect. Sutures were placed with 6-0 polypropylene and removed after 1 week. PPD decreased and attachment level improved. PPD decreased and attachment level improved. The radiographic findings showed improvement of the bone defect morphology.
Conclusion: If the bone defect can be approached from the buccal side, NIPSA is effective in preserving the interdental papillae adjacent to the defect.
