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Global Translational Medicine Comparative analysis of MIF and CF techniques

tooth loss due to periodontal reasons (TLP). At the 3. Results
34
tooth level, multilevel binary logistic regression with
generalized estimation equations was used to relate the 3.1. Characteristics of the study population
independent factors and covariates to the binary outcomes There were 40 males (45.5%) and 48 females (54.5%), with
(e.g., TLP, BOP at T1). Raw odds ratio (OR) and 95% an average age of 63.1 ± 13.8 years, ranging from 30 to
confidence intervals (CI) were obtained from the Wald’s 87 years at baseline. Each patient contributed, on average,
χ statistic. Then, multiple models were estimated to 1.13 teeth to the database, resulting in a total sample of 99
2
adjust by potential confounding factors (at patient’s level, teeth (40 in the MIF group and 59 in the CF group) treated
such as age, sex, smoking, diabetes mellitus, periodontitis by 84 post-graduate residents. Table 1 summarizes the
diagnosis, number of maintenance visits, and duration of demographic characteristics of both groups, the type and
follow-up, as well as clinical data, including the number location of tooth, and the operator level.
of walls, antibiotic use, the type of membrane applied, The sample included 88 patients who underwent either
furcation involvement, number of walls of the defect, defect MIF (n = 36, consisting of 30% SPPF incision technique,
dimensions, and the type of grafting material). Quantitative 47.5% modified papillary preservation incision technique,
outcomes (e.g., CAL gain, PD reduction, KT change, and and 22.5% papillary preservation incision technique) or
GR at T1) were analyzed using linear regression models CF (n = 52) procedures. The mean follow-up period after
estimated with generalized estimation equations to control treatment was 42.0 ± 30.1 months, ranging from 2 to
the within-subject dependence of teeth. Beta coefficients 163 months (median: 34; interquartile range: 19–57).
and 95% CIs were reported. As previously mentioned,
multiple models were estimated. The significance level In terms of group homogeneity, no significant differences
used in the analysis was 5% (α = 0.05). were found between the groups regarding patient-level
covariates, such as sex, age, diabetes mellitus, smoking, and
To ensure sufficient statistical power to detect a clinically periodontitis diagnosis (staging and grading), as well as the
valuable difference between the MIF and CF groups, a number of follow-up visits (p>0.05). Group homogeneity
power analysis using a post hoc estimation was performed. information is presented in Table S2.
A sample size of 99 independent teeth provides 72.3% power
at a 95% confidence level to detect an OR of 3 as significant No significant difference was found in the treating
nd
using a logistic regression model (an OR of 3 is equivalent to residents’ level, with 2 -year residents predominately
comparing rates of 50% and 25%, for example, for BOP rates). contributing to both groups (MIF: 47.6%, CF: 52.3%).
However, since teeth were not independent observations, the 3.2. Analysis of changes in clinical outcomes
power was adjusted to account for the two-level structure
of the data. Each patient provided an average of 1.13 teeth. 3.2.1. Effect of procedure complexity on clinical
Assuming a moderate within-subject correlation of 0.5, outcomes
a correcting coefficient of 1.06 was obtained. Therefore, The mean CAL gain was found to be 2.17 ± 2.18 mm
a sample of 99 dependent teeth was equivalent to 93 for the CF group, in contrast to only 0.59 ± 3.43 mm for
independent observations, yielding an estimated power of the MIF group (Figure 3). Significant differences in CAL
70.0% under the same previous conditions. gain remained between the groups even after adjusting

Table 1. Demographic characteristics of both groups, the type and location of the tooth, and the operator level
Demographic characteristics Total CF MIF
Number of patients 88 52 36
Age, mean (years) 63.1±13.8 63.16 63.45
Sex (M/F) 40/48 25/28 15/20
Follow-up time, mean (months) 42.0±30.1 44.85 38.5
Number of teeth 99 59 40
Type of the tooth (%) (M/P/C/I) 65.7/19.2/4.0/11.1 86.4/6.8/5.1/1.7 35.0/37.5/2.50/25.0
Arch (%) (Max/Man) 44.3/55.6 62.5/37.5 32.2/67.8
Operator level (R1, R2, R3) 13, 42, 29 9, 22, 19 4, 20, 10
Note: R1, R2, and R3 refer to 1 -year residents, 2 -year residents, and 3 -year residents, respectively.
rd
nd
st
Abbreviations: CF: Conventional flap; M/F: Male/female; M/P/C/I: Molar/premolar/canine/incisor; Max/Man: Maxilla/mandible; MIF: Minimally
invasive flap.
Volume 4 Issue 3 (2025) 99 doi: 10.36922/GTM025080015