Comparison of gingival blood flow during healing of simplified papilla preservation and modified Widman flap surgery: a clinical trial using laser Doppler flowmetry

J Clin Periodontol. 2007 Oct;34(10):903-11. doi: 10.1111/j.1600-051X.2007.01119.x.

Abstract

Aim: This prospective randomized-controlled clinical trial compared the gingival blood flow responses following simplified papilla preservation (test) versus modified Widman flap (control).

Materials and methods: Twenty contra-lateral upper sites with pocket depth > or = 5 mm after initial treatment in 10 chronic periodontitis patients were randomly assigned to either test or control treatment, using a split-mouth design. Laser Doppler flowmetry recordings were performed pre-operatively, following anaesthesia, immediately post-operatively and on days 1, 2, 3, 4, 7, 15, 30 and 60, at nine selected sites per flap.

Results: Significant ischaemia was observed at all sites following anaesthesia and immediately post-operatively. At the mucosal flap basis, a peak hyperaemic response was observed on day 1, which tended to resolve by day 4 at the test sites, but persisted until day 7 at the control sites. The buccal and palatal papillae blood perfusion presented the maximum increase on day 7 in both groups and returned to baseline by day 15. Both surgical modalities yielded significant pocket depth reduction, recession increase and clinical attachment gain.

Conclusions: Periodontal access flaps represent an ischaemia-reperfusion flap model. The simplified papilla preservation flap may be associated with faster recovery of the gingival blood flow post-operatively compared with the modified Widman flap.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Dental Plaque
  • Female
  • Gingiva / blood supply*
  • Gingiva / surgery
  • Humans
  • Ischemia / etiology*
  • Laser-Doppler Flowmetry / instrumentation
  • Laser-Doppler Flowmetry / methods*
  • Male
  • Microcirculation
  • Periodontal Pocket / surgery
  • Periodontitis / surgery*
  • Regional Blood Flow
  • Surgical Flaps / blood supply*
  • Time Factors
  • Treatment Outcome
  • Wound Healing / physiology