Single flap approach combined with periosteal pedicle flap as a regenerative procedure: A case report

Why is this case new information? The present case reports that single flap approach may be successfully combined with a periosteal pedicle flap to correct intrabony defects associated with unfavorable conditions of soft tissues located at molar sites. What are the keys to successful management of this case? Careful dissection of the flap to isolate and maintain the integrity pf the periosteal pedicle flap Complete debridement of both the intrabony defects and of the root Stabilization of the periosteal pedicle flap above the defect in order to contribute to the primary intention healing What are the primary limitations to success in this case? Absence of unfavorable anatomical conditions possibly jeopardizing the primary closure of the surgical wound Proximity with mental nerve due to possible lesions during the partial thickness dissection PLAIN LANGUAGE SUMMARY: The present paper explored the use of a surgical technique combining a buccal single flap elevation and a periosteal pedicle to treat a periodontal pocket associated with a deep intrabony defect. A buccal split-thickness incision was performed to both visualize the osseous defect and isolate a periosteal pedicle. The defect was debrided and filled with a combination of a xenograft and gel composed of polynucleotides and hyaluronic acid. The periosteal pedicle was rotated and sutured above the filled defect. The primary split-thickness flap was sutured, covering both the defect and periosteal pedicle. Twelve months after surgery, no periodontal pocket was present. At the radiographic examination, substantial remineralization of the defect was observed.