Shizrah Jamal
Peri-radicular surgery has made significant advancement lately. Access to apical root canal system is gained after flap elevation using various incision techniques. Soft tissue healing after surgery may include gingival recession, papilla recession, changes in probing depth and clinical attachment loss. The aim of the present study was to compare the effects of intrasulcular incison to papilla based incision on periodontal parameters in peri radicular surgery. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane and Cinahl Plus until May 2019. Initial search yielded 72 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, post-operative pain, bleeding and discomfort. Out of the five articles that fit the inclusion criteria, two were RCTs and three were NRCTs. Out of 3 studies, 2 reported significant change in papilla height postoperatively with 75 percent of data significantly affected by type of incision. No significant differences were found in gingival recession, probing depth, gingival, bleeding and plaque indices. Meta-analysis depicted significant difference in probing depth (p = 0.006) and clinical attachment loss (p = 0.0004) between the incision techniques. Whereas, no significant difference was found in gingival recession (p = 0.79 ) and papilla height (p = 0.55). The use of papilla based technique is recommended to prevent loss in probing depth and clinical attachment. The present systematic review demonstrated that gingival recession and papilla height parameters are equally effected by intrasulcular and papilla based incicion. However, more clinical trials are needed to generate a strong conclusion.
