Papilla base incision: a new approach to recession-free healing of the interdental papilla after endodontic surgery

By Velvart P.

Date: 08/2003
Journal: JOE


Purpose: To describe and evaluate a new incision technique (the papilla base incision)

n: 20 patients with mean age of 47.8±, 13.6 years  referred for surgical treatment of persisting apical periodontitis in max and mand anteriors, premolars and molars.

•All teeth are previously root filled with different techniques

•Patients with periodontal disease were excluded (BP, PD >3mm)

•Surgery was performed with magnification of 4.3x with loupes and OM •Flap design:  2 releasing v. incisions connected by papilla base incision and intrasulcular incision

•Flap closure: 6/0 interrupted polyamide sutures for v. incisions. 2-3 polypropylene 7/0 interrupted sutures for papilla base incision. Passive and tension free re-approximation, 1 min. compression

Assessment of healing:

(grade 1) clearly visible defect along the entire incision.

(grade 2) Partially complete healing (parts of the incision were visible and at the same time there were also areas with undetectable healing patterns). (grade 3) Perfect healing was given for undetectable incision lines

Most highlighted Results: 

-All cases showed complete wound closure, no papilla necrosis.

-At time of suture removal (3-5 days):- 1 pt showed delayed healing and scar formation, 3 pts Showed irritation around sutures, remaining pts showed rapid healing.

-At 1 month evaluation: mean difference between ref. point and most coronal point of papilla

0.05±0.39 mm, PD<3mm. 4 sites with visible defect (grade 1),7 with partially detectable incisions (grade 2),

9 with perfect healing (grade 3)

Clinical significance:

After an apical surgery, postoperative recession of the papilla can be prevented with the papilla base flap.