Volumetric Evaluation of the Entire Papilla Preservation Technique and the Non-Incised Papillae Surgical Approach: Effects on Soft Tissue Preservation and Periodontal Regeneration

Abstract Objectives This randomized, controlled clinical trial compared two minimally invasive surgical techniques - the Non-Incised Papillae Surgical Approach (NIPSA) and the Entire Papilla Preservation Technique (EPPT) - in terms of their efficacy in preserving soft tissue architecture and promoting periodontal regeneration. Materials and methods Isolated intrabony defects of 40 patients with stage III/IV periodontitis were randomly assigned to either NIPSA or EPPT treatment. Clinical parameters including probing depth (PD), clinical attachment level (CAL), gingival recession (REC) and papilla height (TP) were evaluated at baseline and 6-months postoperatively. Results Both NIPSA and EPPT showed significant improvements in PD (5.3 ± 2.3mm vs. 4.6 ± 1.7mm) and CAL (4.4 ± 2.2mm vs 3.7 ± 1.9mm), with no statistically significant differences between the groups. Early wound healing was favorable in both techniques, with minimal fibrin clot formation and no biomaterial exposure. Digital analysis of intraoral scans showed comparable preservation of papilla height and width in both groups. Radiographic analyses confirmed defect filling and bone regeneration in both groups. Conclusions Both NIPSA and EPPT are effective surgical options for the periodontal regeneration of deep intrabony defects, offering excellent soft tissue preservation and clinical outcomes. NCT04782921. Clinical Relevance Both techniques remain viable, with the choice depending on the specifics of each defect and the surgeon's preference.