Evaluation of Periodontal Indices Following Use of Two Incision Techniques in Apical Surgery

Introduction: It is important to preserve epithelial and connective tissue attachment at its original level after periapical surgery. The aim of this study was to compare the periodontal parameters after using the papilla base flap and the sulcular full-thickness flap procedures. Methods: Fourteen healthy patients with no periodontal disease referred for surgical treatment of periapical lesions, were included in this study. Periodontal parameters were measured preoperatively and at one-month postoperative interval. The patients were randomly divided into two equal groups. A sulcular full-thickness flap procedure was performed in the first group and papilla base flap procedure in the second. Data were analyzed using t-test, Fisher's exact test and Mann-Whitney U test. Results: The sulcular full-thickness flap procedure resulted in a significant decrease in papilla height and an increase in recession of marginal gingiva compared to the papilla base flap technique. There were no significant differences between the two flap procedures in bleeding on probing, attachment loss, probing depth and gingival index. Conclusion: The use of papilla base flap technique is recommended to prevent opening of the inter-proximal space, aesthetic and biologic problems after apical surgery.