Bone loss after full-thickness and partial-thickness flap elevation

OBJECTIVES: the aim of this study was to histologically assess whether elevation of partial-thickness flaps results in reduced bone alterations, as compared with full-thickness flap preparations.

MATERIAL AND METHODS: in five beagle dogs, both mandibular second premolars (split-mouth design) were subjected to one of the following treatments: Tx1: elevation of a partial-thickness flap over the mesial root of P(2) and performing a notch at the height of the bone. Tx2: elevation of a full-thickness flap over the mesial root of P(2) and performing a notch at the height of the bone. After 4 months, sections were evaluated for: (i) vertical bone loss and (ii) osteoclastic activity using histometry.

RESULTS: elevation of both full- and partial-thickness flaps results in bone loss and elevated osteoclastic activity. Partial-thickness flaps can result in less bone loss than full-thickness flaps, but are subject to some variability.

CONCLUSION: use of partial-thickness flaps does not prevent from all bone loss. The procedure may result most of the times in less bone loss than the elevation of full-thickness flaps. Further research has to evaluate the determinants of effective outcomes of partial-thickness flap procedures.