Post-surgical flap placement following osseous surgery: A short-term clinical evaluation.

Background: The purpose of this study is to examine the relationship between immediate post-surgical flap position and subsequent probing depth measurements following osseous surgery.

Methods: Twenty-four patients treatment planned for osseous surgery after completion of initial therapy and re-evaluation were enrolled. Pressure molded stents were fabricated to serve as a reference for probing depth and relative attachment level measurements prior to surgery. After osseous recontouring was completed, flaps were sutured and compressed, and bone sounding measurements were made as designated by the stent. Patients returned at 3- and 6 months for repeat measurements of probing depth and attachment level.

Results: Twenty-four patients completed surgical treatment and follow-up measurements with a total of 402 treated sites. A statistically significant moderate correlation between immediate post-surgical bone sounding measurements and subsequent probing depth was found at 6 months (R = 0.56, P < 0.001). There was no significant difference between this correlation at 3 and 6 months. The probability of having 6 month probing depth ≤3 mm was 93.5% when the surgical flap was placed within 3 mm of the alveolar crest (286/306 sites) as opposed to 50% when the surgical flap was >3 mm away from the alveolar crest (48/96 sites). Interproximal sites were significantly more likely (P < 0.01) to have probing depths > 3 mm at 3 and 6 months.

Conclusions: Results suggest a statistically significant relationship between immediate post-surgical flap placement and subsequent probing depths. Positioning the surgical flap more closely to the alveolar crest when performing osseous surgery resulted in shallower probing depths at 3 and 6 months.