Page 104 - GTM-4-3

Global Translational Medicine

ORIGINAL RESEARCH ARTICLE
Technique sensitivity hampers outcomes in

periodontal regeneration when performed by
less experienced operators: A retrospective

analysis

Hamzeh Almashni 1 , Ruben Leyton 1 , Abdusalam Alrmali 1,2 ,
Yousef Amrou 1 , Hom-Lay Wang 1 ,and Muhammad H. A. Saleh *
1

1 Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann
Arbor, Michigan, United States of America
2 Department of Oral Medicine, Oral Pathology, and Oral & Maxillofacial Surgery, School of Dentistry,
University of Tripoli, Tripoli, Libya

Abstract

Flap design is a key factor in the clinical outcomes of periodontal regeneration
*Corresponding author:
Muhammad H. A. Saleh (PR). This study compares the effectiveness of minimally invasive flap (MIF) to
(muhsaleh@umich.edu) conventional flap (CF) techniques in PR procedures performed by periodontic
Citation: Almashni H, Leyton R, residents. The study also addresses how technique sensitivity may influence
Alrmali A, Amrou Y, Wang H, clinical outcomes when performed by less experienced operators. A retrospective
Saleh MHA. Technique sensitivity study was conducted on patients who underwent PR from January 2012 to
hampers outcomes in periodontal
regeneration when performed January 2023 at the School of Dentistry, University of Michigan. Flap techniques
by less experienced operators: were classified as MIF or CF, and clinical outcomes, including bleeding on probing
A retrospective analysis. Global (BOP), probing depth (PD), clinical attachment level (CAL), gingival recession (GR),
Transl Med. 2025;4(3):96-105.
doi: 10.36922/GTM025080015 changes in keratinized gingiva, and tooth loss, were evaluated. Statistical analysis
using generalized estimation equations was performed for the overall sample and
Received: February 17, 2025
separately for each group. The study sample consisted of 40 male (45.5%) and
1st revised: July 10, 2025 48 female patients (54.5%), with an average age of 63.1 ± 13.8 years and a mean
2nd revised: July 20, 2025 follow-up of 42 months. No significant differences were found between the MIF and
CF groups regarding the reduction in PD or GR. However, the CF group exhibited
3rd revised: July 25, 2025
a superior gain in CAL (p=0.005) and a greater decrease in BOP after adjustment
Accepted: July 25, 2025 for confounders (odds ratio: 4.44, p=0.0276). Tooth type and defect depth were
Published online: September 3, identified as significant factors affecting clinical outcomes. Both techniques were
2025 effective in treating periodontal defects. However, the CF approach demonstrated
Copyright: © 2025 Author(s). a greater improvement in CAL and BOP. Given the technique-sensitive nature of
This is an Open Access article MIF, the limited clinical experience of resident operators may have contributed
distributed under the terms of the
Creative Commons Attribution to the diminished performance of MIF observed in this study. Simpler surgical
License, permitting distribution, techniques may offer comparable effectiveness to more complex, superior surgical
and reproduction in any medium, techniques in a university-based setting when performed by less experienced
provided the original work is
properly cited. operators.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Guided tissue regeneration; Periodontal disease; University-based services;
regard to jurisdictional claims in
published maps and institutional Smoking
affiliations.

Volume 4 Issue 3 (2025) 96 doi: 10.36922/GTM025080015