Clinical and radiographic evaluation of non-incised papilla surgical approach (NIPSA) versus modified minimally invasive surgical technique (M-MIST) in treatment of intraosseous defects in patients with stage III periodontitis: A randomized clinical trial

Background: Minimally invasive surgical (MIS) procedure" in multiple and isolated intra-osseous defects maintained the entire interdental papilla with significant improvement in clinical and radiographic outcomes compared to traditional periodontal surgeries. Methods: Thirty-two intra-osseous defects in 15 patients were enrolled for this study and were randomly allocated to both groups i.e. (16 defects) per group. Patients in group I (test group) went for Non-Incised Papilla Surgical Approach (NIPSA), while, in group II (control group), patients received Modified Minimally Invasive Surgical Technique (M-MIST). All clinical and radiographic periodontal parameters were measured at baseline, six months and twelve months. Results: Patients in both groups showed significant improvements in clinical and radiographic outcomes after twelve months of follow-up including reductions in CAL, potential effect in post-surgical patients’ satisfaction and intra-osseous defect fill. Absence of significant difference regarding intergroup comparisons. The minimal surgical flap design plays a very important role in the success of the therapy, creating and maintaining a stable space for the clot. Conclusions: NIPSA is viewed as a promising minimally invasive technique even in hopeless teeth with severe periodontal bone loss, clinical attachment loss to the apex and minimal keratinized tissue