Clinical comparison of different flap advancement techniques to periosteal releasing incision in guided bone regeneration: A randomized controlled trial

Abstract

Objectives To compare Double Flap Incision (DF), Coronally Advanced Lingual Flap (CALF), and Modified Periosteal Releasing Incision (MPRI) to Periosteal Releasing Incision (PRI) in flap advancement, postoperative complications in augmentation using titanium mesh.

Material and methods Forty patients with partially edentulous posterior mandibles were randomly assigned to the four groups. We evaluated: (a) Flap advancement in mm (Primary outcome). (b) Pain using the Numerical Rating scale (NRS). (c) Swelling using the Visual Analogue Scale (VAS). (d) Exposure in mm and exposure percentage at 1 week to 6 months.

Results The CALF showed the highest mean flap advancement of 19.9 (+/- 5.0) mm while the PRI showed the lowest; 10.2 (+/- 1.7) mm. The difference between groups was statistically significant (P value <.0001). MPRI showed the highest pain score of 5.3 (+/- 1.3) while the DF showed the lowest; 2.39 (+/- 1.7). Swelling did not show a significant difference between groups. MPRI showed the highest exposure mean; 18.6 mm (+/- 26.3) while CALF showed the lowest; 2.5 mm (+/- 4.0). PRI showed the highest exposure percentage; 7.4% (+/- 9.3) while CALF showed the lowest; 0.4% (+/- 0.7). The difference between groups was insignificant.

Conclusions CALF reported highest advancement, least complications while PRI reported the highest complications