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Crestal bone resorption after the application of two periodontal surgical techniques: a randomized, controlled clinical trial.

AIM
To radiographically assess, by means of digital subtraction radiography, crestal bone loss following two periodontal surgical techniques, over a period of 6 months.


MATERIAL AND METHODS
A total of 30 chronic periodontitis patients participated in this randomized controlled clinical trial and were separated into two groups. Modified Widman flap was applied in the control group and apically positioned flap, without intervention to the bone, in the experimental group. Clinical measurements (plaque index, gingival bleeding index, probing pocket depth and clinical attachment level) were recorded at baseline, 6 weeks, 3 and 6 months after surgery. Digital radiographs were taken at baseline, 1, 3, 6 weeks, 3 and 6 months after surgical treatment and subtracted digitally in pairs.


RESULTS
Both groups showed statistically significant improvement of clinical parameters. Statistically significant differences between the two groups were observed only in probing pocket depth (PPD) at 6 weeks interval, where the test group showed more reduction (smallest statistically significant differences observed, SSSDO = 0.64). Both groups showed the same rate of crestal bone resorption.


CONCLUSIONS
Bone resorption of the alveolar crest is a phenomenon that is observed as a consequence of periodontal surgical treatment without significant differences between the two techniques. Furthermore, both surgical techniques lead to satisfactory clinical results, indicating that bone removal during periodontal surgical treatment is not always necessary.