Single flap approach with and without guided tissue regeneration and a hydroxyapatite biomaterial in the management of intraosseous periodontal defects

Background: The single flap approach (SFA) is aminimallyinvasive procedure designed for periodontal reconstructive procedures of intraosseous periodontal defects characterized bya dominant unilateral, buccal or oral, extension. This study evaluates the adjunctive effect of guided tissue regeneration(GTR) combined with a hydroxyapatite (HA) biomaterial in the management of intraosseous periodontal defects accessed with SFA compared to SFA alone. Methods: Twenty-four intraosseous defects (in 24 patients) were randomly allocated to treatmentwith SFA or SFA + HA/GTR. Clinical outcomes were assessed6 months postsurgery. Results: Five sites in the SFA + HA/GTRgroup showed incomplete closure at week 2, which resolved spontaneously. There were no statistically significant or clinicallymeaningful differences in mean (±SD) clinical attachment gain (4.7 ± 2.5 versus 4.4 ± 1.5 mm), probing depth reduction (5.3 ± 2.4 versus 5.3 ± 1.5 mm), and gingival recession increase (0.4 ± 1.4 versus 0.8 ± 0.8 mm) between the SFA + HA/GTR and SFA groups.Conclusions: SFA with and without HA/GTR seems to be a valuable minimally invasive approach in the treatment of deep intraosseous periodontal defects. Under the present experimental conditions, the additional HA/GTR protocol offers no significant adjunctive effect.