Methods: Apical surgeries were performed on 98 teeth (8 front teeth, 30 premolars, and 60 molars). In 65 cases surgical access was achieved by means of a sulcular incision technique without the involvement of the adjacent periodontia and the interproximal papillae and in 33 cases by means of a submarginal trapezoidal technique. Periodontal parameters (probing depth (PD), level of the gingival margin (GM), clinical attachment loss (CAL), loss of papilla height and tooth mobility (Periotest values)) were recorded at baseline and 6 months following surgery. Scar formation was evaluated my means of photographs taken preoperatively and at the end of the observation period. Treatment outcome was compared clinically and radiographically.
Results: No significant differences between the two incision techniques were found regarding changes in CAL and tooth mobility. No loss of papilla height was found in both groups. A slight gingival recession (0.2 mm ± 0.4 mm) corresponding to the decrease in pocket depths occurred on the buccal aspect with the marginal incision technique. Tooth mobility was significantly increased in both groups immediately and 6 month after surgery. Scar formation was considerably more unfavourable with the submarginal incision technique. The respective incision technique had no significant effect on the success rate of the treatment.
Conclusions: The new incision technique allows an excellent access to the apical region with the possibility to evaluate the entire buccal bone. Scar formation is minimal since no horizontal incisions are needed and no loss of the papilla is observed. Gingival recession is negligible when a microsurgical technique is applied.