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Global Translational Medicine Comparative analysis of MIF and CF techniques

Figure 3. CAL gain and PD reduction for MIF and CF at T0 and T1. (A) CAL gain; (B) PD reduction. The mean CAL gain decreased by 2.17 ± 2.18 mm
from T0 to T1 for the CF group, in contrast to only 0.59 ± 3.43 mm for the MIF group. T0 and T1 refer to the 1 and 2 time points, respectively
nd
st
Abbreviations: CAL: Clinical attachment level; CF: Conventional flap; MIF: Minimally invasive flap; PD: Probing depth.
for confounding factors (p<0.001), indicating a greater
CAL gain for the MIF group (Tables 2 and S3). Both the
MIF and the CF groups showed improvements in PD and
BOP at the follow-up. However, no significant differences
were observed between the two groups in PD reduction
(p=0.218) (Table 3). BOP was slightly higher in the MIF
group at T1 (p=0.047) (Figure 4). Similarly, for GR, no
statistically significant difference was found between the
CF and MIF groups (p=0.073) (Tables S4-S7).
3.2.2. Effect of covariates on clinical outcomes Figure 4. Percentage of BOP changes by group. The CF group
demonstrated improved BOP changes compared to the MIF group from
The depth of the defect was a critical factor, as it negatively T0 to T1. A total of 41.4% of teeth reported an improved BOP status in the
impacted the CAL gain outcome (p=0.003) (Table 2). Teeth CF group, but only 17.6% in the MIF group. T0 and T1 refer to the 1 and
st
in the Stage 3 or 4 patients resulted in higher PD reductions 2 time points, respectively.
nd
compared to Stage 1 patients (p=0.003, Table S8). Deeper Abbreviations: BOP: Bleeding on probing; CF: Conventional flap; MIF:
and larger defects were correlated to less PD reductions Minimally invasive flap.
(p=0.001 and p=0.020, respectively) (Tables 3 and S8).
Considering the CAL gain, several factors contributed
3.3. Analysis of tooth loss due to periodontitis to the superior gain in the CF group compared to the MIF

MIF and CF showed the same TLP rate (p=0.521). A more group. The insufficient gingival phenotype (keratinized
significant occurrence of TLP was noted in teeth with width and thickness) that was found to be significantly
furcation involvement, regardless of the flap design (OR: lower in the MIF group can negatively impact the results.
3,35
4.3, p=0.035). According to Tonetti et al. and a recent review by
Levine et al., a thin gingival phenotype appears to be at
3,35
4. Discussion greater risk of exhibiting GR in response to regenerative
The study investigated the effectiveness of two flap designs, procedures than a thick phenotype. The keratinized
MIF and CF, in treating isolated intra-bony and furcation tissue width appears to play a role in flap stability and flap
36
defects within a periodontics residency program. Both micromotion prevention, affecting healing. De Ry et al.
techniques were effective in treating periodontal defects. presented 10-year follow-up results of PR with enamel
No statistically significant differences were found between matrix derivatives, reporting that maxillary molars were
the two groups regarding PD, GR, or TLP. Nonetheless, correlated with an increased risk for CAL loss. This aligns
notable differences emerged between the MIF and CF with the findings in our cohort, with the CF group mostly
groups in terms of CAL gain and BOP reduction. in the mandibular arch compared to the MIF group.

Volume 4 Issue 3 (2025) 100 doi: 10.36922/GTM025080015