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Global Translational Medicine Comparative analysis of MIF and CF techniques

than the MIF group at T1, as reported by the multiple Our study was conducted in a university-level setting,
regression model. This indicates a higher level of persistent where the procedures were executed by residents under
inflammation in the MIF group in our cohort, which is the supervision of a faculty member, potentially affecting
42
39
mainly located in the maxil. This aligns with a previous the results. Lizio et al. concluded that the level of the
study by De Ry et al., which reported that maxillary operator’s expertise is relevant in conditioning the final
36
molars are more prone to complications than mandibular results. Yet, the study provides valuable insights into PR
molars. efficacy, particularly for those in training or with limited
experience. Both MIF and CF techniques were effective
GR improvement was observed in both groups, with in treating periodontal defects. These findings can guide
the CF group showing slightly better, but insignificant, periodontists in selecting the most appropriate surgical
improvement compared to the MIF group at T1. This techniques based on individual patient needs and clinical
might be attributed to the difference in gingival phenotype goals, ultimately enhancing overall outcomes.
discussed earlier. Some relapse might also be expected
over the follow-up period. In our cohort, longer follow-up Studies with more standardized protocols of higher
periods were associated with a higher incidence of GR. sample sizes might be needed to further evaluate the efficacy
of MIF techniques compared to CF on PR outcomes,
The robustness of our investigation lies in its especially in treating posterior multirooted teeth.
comprehensive examination of the effectiveness of
surgical methodologies in facilitating PR, juxtaposed with 5. Conclusion
the operator’s proficiency level. All patients in this study
were compliant with supportive periodontal therapy. Both MIF and CF techniques conducted by periodontic
In addition, our analysis encompassed consideration graduate residents within a university-based setting
of various systemic and localized variables pertinent to effectively treated periodontal defects. However, the
CF approach demonstrated superior improvements in
the procedure. However, the retrospective nature of the CAL and BOP. In addition, simpler flap designs can
study limits our ability to establish a causal relationship offer comparable outcomes to more complex techniques
between flap design and treatment outcomes. Prospective, conducted by less experienced operators in less-than-ideal
randomized controlled trials would provide more clinical situations.
substantial evidence, especially when considering novel
techniques for gingival augmentation, as well as cell Acknowledgments
technologies, collagen matrices, mucoderm, mucograft,
gene therapy, and gene-activated materials. 40,41 The authors would like to thank Dr. Jonathan Misch for
Furthermore, the majority of the teeth involved providing the clinical photographs of flap techniques for
were molars. Nevertheless, there were no differences publication in this study.
attributable to technique between different tooth locations Funding
or between furcation and non-furcation teeth. In addition,
the study’s reliance on a university-based environment This study was partly supported by the Graduate
may introduce selection bias, potentially affecting the Periodontics Fund, University of Michigan School of
generalizability of the findings. Despite attempts to adjust Dentistry.
for confounding variables, other unmeasured factors may Conflict of interest
influence treatment outcomes, oral hygiene habits, and
systemic health conditions. The variability in follow-up The authors declare that they have no competing interests.
duration, ranging from 12 to 163 months, may introduce
bias and affect the interpretation of long-term treatment Author contributions
outcomes. The study observed a varied distribution of flap Conceptualization: Hamzeh Almashni, Abdusalam Alrmali
techniques intraorally, which may introduce heterogeneity Investigation: Hamzeh Almashni, Ruben Leyton, Yousef
in treatment outcomes. Standardization of treatment Amrou
protocols could enhance the reliability of comparisons Methodology: Hamzeh Almashni, Abdusalam Alrmali,
between groups. While the study evaluated several clinical Muhammad H. A. Saleh
parameters, other important factors, such as patient- Project administration: Hamzeh Almashni
reported outcomes and radiographic assessments, were Writing – original draft: Hamzeh Almashni, Ruben Leyton,
not included due to the lack of systematic collection of Abdusalam Alrmali
such data. This limited the comprehensiveness of the Writing – review & editing: Muhammad H. A. Saleh, Hom-
analysis. Lay Wang

Volume 4 Issue 3 (2025) 102 doi: 10.36922/GTM025080015